Bae Joo-Yul, Won Hee-Jae, Seo Dong-Kyo
Department of Orthopaedic Surgery, GangNeung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, South Korea.
Orthopedist, Department of Orthopaedic Surgery, GangNeung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, South Korea.
J Foot Ankle Surg. 2017 Jul-Aug;56(4):868-873. doi: 10.1053/j.jfas.2017.03.003.
We report a case of valgus ankle degenerative arthritis due to chronic isolated deltoid insufficiency combined with tibial varus that was treated successfully with ankle joint preserving surgery. A 63-year-old male complained of right lateral ankle pain with 10 minutes of maximal pain-free walking time. The assessed American Orthopaedic Foot and Ankle ankle-hindfoot scale score was 33 points. The ankle joint showed 18° of valgus deformity with 6° of tibia varus. Medial displacement calcaneal osteotomy, supramalleolar open wedge osteotomy, and deltoid ligament imbrication were performed. At the 2-year follow-up examination, the ankle joint showed 10° of valgus and the tibial plafond showed flattening. The hindfoot showed 7° of valgus. He could run for 2 hours on the treadmill without pain. The American Orthopaedic Foot and Ankle ankle-hindfoot scale score was 90 points. In conclusion, valgus ankle degenerative arthritis with isolated deltoid insufficiency and tibial varus could be treated successfully with realignment using a double osteotomy and additional deltoid imbrication.
我们报告一例因慢性孤立性三角肌功能不全合并胫骨内翻导致的外翻踝关节退行性关节炎，通过保留踝关节手术成功治疗。一名63岁男性主诉右外侧踝关节疼痛，最大无痛步行时间为10分钟。评估的美国矫形足踝协会踝 - 后足量表评分为33分。踝关节显示18°外翻畸形，伴有6°胫骨内翻。进行了内侧移位跟骨截骨术、内踝上开放性楔形截骨术和三角韧带重叠缝合术。在2年的随访检查中，踝关节显示10°外翻，胫骨平台变平。后足显示7°外翻。他可以在跑步机上跑2小时而无疼痛。美国矫形足踝协会踝 - 后足量表评分为90分。总之，孤立性三角肌功能不全和胫骨内翻的外翻踝关节退行性关节炎可通过双截骨术和额外的三角韧带重叠缝合术进行重新排列而成功治疗。
