LaPorta Guido A, Susek Mehgan M
Chief, Department of Podiatric Medicine and Surgery, Geisinger Community Medical Center, Scranton, PA; Residency Director, Geisinger Community Medical Center, Scranton, PA; and Fellowship Director, Northeast Regional Foot and Ankle Institute Limb Salvage and Reconstructive Surgery, Scranton, PA.
Podiatrist, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA.
J Foot Ankle Surg. 2016 May-Jun;55(3):645-9. doi: 10.1053/j.jfas.2015.08.012. Epub 2015 Oct 1.
Guided growth is useful in correcting pediatric angular deformities. Ankle valgus is a coronal plane deformity and is often seen in skeletally immature patients with congenital or acquired lower extremity pathologic features. Temporary hemiepiphysiodesis with a percutaneous transphyseal medial malleolar screw is a surgical treatment capable of correcting the angular deformity and can offer effective correction. In the present case study, a 12-year-old male with dorsal-lateral peritalar subluxation and ankle valgus underwent a reconstructive procedure and temporary hemiepiphysiodesis with a percutaneous medial malleolar screw. After removal of the screw, reduction of his peritalar subluxation was achieved, improving his lateral-distal tibial angle from 81° preoperatively to 89° at the final follow-up examination. The patient returned to his preoperative sporting activities and ambulated comfortably and pain free in sneakers with orthotics. In conclusion, temporary hemiepiphysiodesis with a transphyseal medial malleolar screw is an effective treatment option for ankle valgus in a skeletally immature individual.
引导性生长在矫正儿童角状畸形方面很有用。足外翻是一种冠状面畸形,常见于骨骼未成熟且患有先天性或后天性下肢病理特征的患者。经皮经骨骺内侧踝关节螺钉临时半骨骺阻滞术是一种能够矫正角状畸形的手术治疗方法,且能提供有效的矫正效果。在本病例研究中,一名患有背外侧距骨周围半脱位和足外翻的12岁男性接受了重建手术及经皮内侧踝关节螺钉临时半骨骺阻滞术。取出螺钉后,其距骨周围半脱位得到复位,在最后一次随访检查时,其胫骨干骺端外侧角从术前的81°改善至89°。患者恢复了术前的体育活动,穿着带有矫形器的运动鞋行走舒适且无痛。总之,经骨骺内侧踝关节螺钉临时半骨骺阻滞术是骨骼未成熟个体足外翻的一种有效治疗选择。