Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Seongnam, Gyeonggi 13620, South Korea.
Department of Mathematics, College of Natural Sciences, Ajou University, 206 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi 16499, South Korea.
Foot Ankle Surg. 2020 Jan;26(1):110-115. doi: 10.1016/j.fas.2018.12.008. Epub 2018 Dec 31.
This study evaluate the radiographic changes in the mid-tarsal joint, including the calcaneocuboid and talonavicular (TN) joints after calcaneal lengthening for planovalgus deformity in children.
This study included 38 patients (68 feet) who underwent calcaneal lengthening for planovalgus deformity. Radiographic osteoarthritic changes at the CC or TN joint were defined as modified Kellgren-Lawrence grade of ≥1.
Among the 68 feet, 31 feet (45.6%) showed radiographic osteoarthritic changes at the CC joint and 20 (29.4%) showed changes at the TN joint. Risk of radiographic osteoarthritic changes at the CC joint was associated with increased age at surgery (OR = 1.2, p = 0.038). Risk of radiographic osteoarthritic changes at the TN joint was associated with increased age at surgery (OR = 2.2; p = 0.002), preoperative AP talus-1st metatarsal angle (OR = 1.1; p = 0.044), and degree of CC subluxation (OR = 2.1; p = 0.007).
Surgeons should consider the risk factors in the surgical correction of planovalgus deformity to prevent mid-tarsal arthritis.
本研究评估了跟骨延长术后中跗关节（包括跟骰和跗舟关节）的影像学变化，以了解儿童平足外翻畸形的治疗效果。
本研究纳入了 38 名（68 足）接受跟骨延长术治疗平足外翻畸形的患者。将 CC 或 TN 关节的放射学骨关节炎改变定义为改良 Kellgren-Lawrence 分级≥1 级。
在 68 只足中，31 只（45.6%）出现 CC 关节的放射学骨关节炎改变，20 只（29.4%）出现 TN 关节的改变。CC 关节发生放射学骨关节炎改变的风险与手术时年龄较大有关（OR=1.2，p=0.038）。TN 关节发生放射学骨关节炎改变的风险与手术时年龄较大（OR=2.2；p=0.002）、术前 AP 距骨-第一跖骨角（OR=1.1；p=0.044）和 CC 半脱位程度（OR=2.1；p=0.007）有关。
外科医生在进行平足外翻畸形的手术矫正时，应考虑这些风险因素，以预防中跗关节炎。
