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采用距下关节活动锻炼治疗II期成人获得性平足畸形

Treatment of Stage II Adult Acquired Flatfoot Deformity With Subtalar Arthroereises.

作者信息

Zhu Yuan, Xu Xiang-Yang

机构信息

Foot Ankle Center, Department of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (YZ)Department of Orthopedics, Ruijin Hospital, Shanghai, China (XX).

Foot Ankle Center, Department of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (YZ)Department of Orthopedics, Ruijin Hospital, Shanghai, China (XX)

出版信息

Foot Ankle Spec. 2015 Jun;8(3):194-202. doi: 10.1177/1938640014548320. Epub 2014 Aug 24.

Abstract

UNLABELLED

The role of arthroereises in the treatment of adult acquired flatfoot deformity (AAFD) has been controversial. This study aims to evaluate the outcome of subtalar arthroereisis in treating stage II AAFD. A total of 24 feet with stage II AAFD were treated surgically between 2009 and 2011 using subtalar arthroereisis. The average follow-up was 29.7 months (range = 24 to 35 months). The average postoperative AOFAS (American Orthopaedic Foot and Ankle Society) Ankle-Hindfoot Scale score was 85.6 (compared with 51.7 preoperatively). Average preoperative talar-first metatarsal angle and talonavicular coverage angle were -13.9° and 38.3°, respectively. The average postoperative angles were 1.6° and 11.2°, respectively (P < .01). No deformity recurrences were found at the time of last follow-up, with the exception of 1 case. Subtalar arthroereisis appears to be a reasonable treatment option for stage IIA and IIC AAFD. It can be used alone to correct mild hindfoot valgus, and it can also be performed with a calcaneal osteotomy to gain more correction in severe stage II AAFD.

LEVELS OF EVIDENCE

Therapeutic, Level IV: Retrospective Case Series.

摘要

未标注

关节松动术在成人获得性平足畸形(AAFD)治疗中的作用一直存在争议。本研究旨在评估距下关节松动术治疗II期AAFD的疗效。2009年至2011年间,共对24例II期AAFD患者的足部采用距下关节松动术进行手术治疗。平均随访时间为29.7个月(范围为24至35个月)。术后美国矫形足踝协会(AOFAS)踝-后足评分平均为85.6分(术前为51.7分)。术前距骨-第一跖骨角和距舟覆盖角平均分别为-13.9°和38.3°。术后平均角度分别为1.6°和11.2°(P <.01)。除1例患者外,末次随访时未发现畸形复发。距下关节松动术似乎是IIA期和IIC期AAFD的一种合理治疗选择。它可单独用于矫正轻度后足外翻,也可与跟骨截骨术联合进行,以在严重的II期AAFD中获得更大程度的矫正。

证据水平

治疗性,IV级:回顾性病例系列。

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