Service de chirurgie orthopédique pédiatrique, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse, France.
Service de chirurgie orthopédique pédiatrique, hôpital universitaire Necker-Enfants Malades, 149, rue de Sèvres, 75743 Paris, France.
Orthop Traumatol Surg Res. 2019 Feb;105(1S):S187-S198. doi: 10.1016/j.otsr.2018.03.010. Epub 2018 Apr 27.
Idiopathic pes planus is common and usually physiologic. Decompensation, when it occurs, may be obvious or on the contrary difficult to identify, raising challenges in patient selection for surgical treatment. The physical examination of a child with pes planus must include an evaluation in the supine position, which helps to adjust the amount of correction during surgery. The many reported surgical procedures include repositioning (talus-reseating, subtalar implants and calcaneo-stop screw), osteotomies and joint fusions. The primary treatment goal is to achieve full architectural correction of the deformity. Selection of the procedure depends on patient age and reducibility of the deformity. The joint lines should be preserved whenever possible. Triceps surae contracture should be sought and corrected if found.
特发性扁平足很常见，通常是生理性的。失代偿时，可能很明显，也可能很难识别，这给手术治疗的患者选择带来了挑战。扁平足患儿的体格检查必须包括仰卧位评估，这有助于调整手术中的矫正程度。报道的许多手术方法包括重新定位（距骨复位、跗骨植入物和跟骨止点螺钉）、截骨术和关节融合术。主要的治疗目标是实现畸形的完全结构矫正。手术方法的选择取决于患者的年龄和畸形的可还原性。只要有可能，就应保留关节线。应寻找并纠正三头肌挛缩。
