Kadhim Muayad, Miller Freeman
Department of Orthopaedics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA.
J Pediatr Orthop B. 2014 Sep;23(5):400-5. doi: 10.1097/BPB.0000000000000073.
Pes planovalgus deformity is common in children with cerebral palsy. In planovalgus foot, the talus subluxates medially, the calcaneus is in valgus, and the forefoot is in supination and external rotation related to the midfoot. In young children, mild planovalgus feet can be managed with orthotics. Surgery is indicated if the deformity is not reducible or if the patient cannot tolerate orthotics during functional activities. The surgery can be calcaneal lengthening or subtalar fusion to restore a stable plantigrade foot and achieve hindfoot correction. Medial column fusion is important to reconstruct the medial arch in severe planovalgus feet.
扁平外翻足畸形在脑瘫儿童中很常见。在扁平外翻足中，距骨向内侧半脱位，跟骨呈外翻，前足相对于中足处于旋后和外旋状态。对于幼儿，轻度扁平外翻足可以使用矫形器进行治疗。如果畸形不可复位或患者在功能活动期间无法耐受矫形器，则需要进行手术。手术可以是跟骨延长或距下关节融合，以恢复稳定的足底着地足并实现后足矫正。对于严重的扁平外翻足，内侧柱融合对于重建内侧足弓很重要。
