O'Neill D B, Micheli L J
Division of Sports Medicine, Boston Children's Hospital, Massachusetts 02115.
Am J Sports Med. 1989 Jul-Aug;17(4):544-9. doi: 10.1177/036354658901700416.
A retrospective review was undertaken of 16 adolescent patients (20 feet) with tarsal coalitions. All patients were active in sports and were seen in the Sports Medicine Clinic. Ages ranged from 9 to 17 years (average, 13 years). Failing conservative therapy, 18 feet had resection of the tarsal bar; 1 patient (2 feet) had bilateral extraarticular subtalar arthrodeses. The patients were seen in followup an average of 5.1 years postoperatively (range, 2 to 10 years). An objective ankle/foot score was developed and all patients improved their score postoperatively, with the average score being improved 25%. Nineteen of 20 feet (95%) had excellent or good postoperative results by the ankle/foot score, while 17 of 20 (85%) had an excellent or good subjective result. Two bars in two feet (10%), both in the same patient, recurred. There were six patients with preoperative talar beaking, and all had an excellent or good followup result. All males returned to their previous level of competition in sports, while three female patients (three feet) gave up sports. Resection of tarsal coalitions, even in the presence of talar beaking without other degenerative changes, yields consistently good follow-up results.
对16例患有跗骨联合的青少年患者（20只足）进行了回顾性研究。所有患者均积极参与体育运动，且在运动医学诊所就诊。年龄范围为9至17岁（平均13岁）。18只足在保守治疗失败后进行了跗骨桥切除术；1例患者（2只足）进行了双侧距下关节外融合术。术后平均随访5.1年（范围为2至10年）。制定了客观的踝/足评分，所有患者术后评分均有所提高，平均提高了25%。根据踝/足评分，20只足中有19只（95%）术后结果为优或良，而20只足中有17只（85%）主观结果为优或良。同一患者的两只足中有两根骨桥复发（10%）。有6例患者术前存在距骨喙突，所有患者随访结果均为优或良。所有男性患者均恢复到之前的运动竞技水平，而3例女性患者（3只足）放弃了运动。即使存在距骨喙突且无其他退行性改变，跗骨联合切除术的随访结果也始终良好。
