Pavone V, Vescio A, Di Silvestri C A, Andreacchio A, Sessa G, Testa G
Department of General Surgery and Medical Surgical Specialties - Section of Orthopaedics and Traumatology, University Hospital 'Policlinico-Vittorio Emanuele', University of Catania, Italy.
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
J Child Orthop. 2018 Dec 1;12(6):582-589. doi: 10.1302/1863-2548.12.180032.
Flexible flatfoot (FFF) is a widespread condition in juvenile patients. If symptomatic, FFF can require surgical treatment. The calcaneo-stop procedure has shown excellent clinical and radiographic outcomes and low rates of complications. The aim of the present study was to assess the sport practice of young athletes affected by FFF having undergone the calcaneo-stop procedure.
Between 2008 and 2016, 68 sport practitioners were bilaterally treated by the calcaneo-stop procedure, for a total of 136 FFF cases. Clinical evaluation, including the American Orthopedic Foot and Ankle Score (AOFAS), the Yoo et al score and The Foot & Ankle Disability Index (FADI) and FADI Sport scores were assessed. Radiographic evaluation was based on measurement of talar declination, Costa-Bertani's angle and calcaneal pitch.
Mean follow-up was 57.6 months (sd 16.8). The AOFAS score mean increased from 79.3 (sd 5.7) to 97.3 (sd 4.5) three years after surgery. The Yoo score improved from 3.1 (sd 1.0) preoperatively to 11.7 (sd 0.6) three years after surgery. The FADI Sport subscale mean improved from 74.1 (sd 10.4) preoperatively to 95.9 (sd 4.9) three years after surgery.Costa-Bertani's angle decreased from 156.1° (sd 4.2°) to 135.8° (sd 7.3°) at three years postoperatively; mean talar declination angle decreased from 44.2° (sd 6.3°) to 30.6° (sd 3.2°) at three years postoperatively and mean calcaneal pitch increased from 12.6° (sd 2.3°) to 16.3° (sd 1.3°) at three years postoperatively.
Adolescent patients who underwent the calcaneo-stop procedure reported satisfactory outcomes in terms of clinical and radiological evaluations. Moreover, our results showed an improvement of sport activity levels, with patients recovering sports activity within three months of surgery and without limitation in the execution of preferred activities.
IV.
柔性扁平足（FFF）在青少年患者中很常见。如果出现症状，FFF可能需要手术治疗。跟骨制动手术已显示出优异的临床和影像学效果以及较低的并发症发生率。本研究的目的是评估接受跟骨制动手术的FFF青少年运动员的运动情况。
2008年至2016年期间，68名从事体育运动的患者接受了双侧跟骨制动手术，共136例FFF病例。进行了临床评估，包括美国矫形足踝评分（AOFAS）、Yoo等人的评分以及足踝残疾指数（FADI）和FADI运动评分。影像学评估基于距骨倾斜度、科斯塔 - 贝尔塔尼角和跟骨倾斜度的测量。
平均随访时间为57.6个月（标准差16.8）。术后三年，AOFAS评分平均从79.3（标准差5.7）提高到97.3（标准差4.5）。Yoo评分从术前的3.1（标准差1.0）提高到术后三年的11.7（标准差0.6）。FADI运动子量表平均分从术前的74.1（标准差10.4）提高到术后三年的95.9（标准差4.9）。术后三年，科斯塔 - 贝尔塔尼角从156.1°（标准差4.2°）降至135.8°（标准差7.3°）；术后三年，平均距骨倾斜角从44.2°（标准差6.3°）降至30.6°（标准差3.2°），平均跟骨倾斜度从12.6°（标准差2.3°）增至16.3°（标准差1.3°）。
接受跟骨制动手术的青少年患者在临床和影像学评估方面报告了令人满意的结果。此外，我们的结果显示运动活动水平有所改善，患者在术后三个月内恢复了体育活动，并且在进行首选活动时没有限制。
IV级。
