Gobbo Daiana Kerry Picanço, Severino Nilson Roberto, Ferreira Ricardo Cardenuto
Departamento de Ortopedia e Traumatologia, Santa Casa de São Paulo, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2019 May;54(3):275-281. doi: 10.1055/s-0039-1692445. Epub 2019 Jun 27.
The present study aims to evaluate the ability of triple arthrodesis in eliminating the main complaints presented by patients with adult acquired flatfoot deformity (AAFD): 1) disabling hindfoot pain; 2) major deformities, such as medial arch collapse, valgus, abduction, and supination. A total of 17 patients (20 feet) with advanced AAFD who underwent surgical correction by triple arthrodesis were evaluated after a mean follow-up period of 43 months (range: 18-84 months). The average age of the patients at surgery was 62 years old (range: 38-79 years old). The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score were used to assess the final results. According to the VAS, the average residual pain was 3 points; the AOFAS hindfoot score points increased 23% after the surgery; and the correction of deformities was considered satisfactory in 10 out of 20 feet; partially satisfactory in 4 out of 20 feet; partially unsatisfactory in 5 out of 20 feet; and unsatisfactory in 1 out of 20 feet. Despite the high index of bone fusion after triple arthrodesis, which is the gold standard treatment in advanced AAFD, the incomplete correction of major deformities and the persistence of residual pain contributed to a high disappointment rate of the patients with the surgical results.
本研究旨在评估三关节融合术消除成人获得性平足畸形（AAFD）患者主要症状的能力：1）致残性后足疼痛；2）主要畸形，如内侧足弓塌陷、外翻、外展和旋后。 对17例（20足）接受三关节融合术手术矫正的晚期AAFD患者进行了评估，平均随访期为43个月（范围：18 - 84个月）。患者手术时的平均年龄为62岁（范围：38 - 79岁）。采用疼痛视觉模拟量表（VAS）和美国矫形足踝协会（AOFAS）后足评分来评估最终结果。 根据VAS，平均残余疼痛为3分；手术后AOFAS后足评分增加了23%；20足中10足的畸形矫正被认为满意；20足中4足部分满意；20足中5足部分不满意；20足中1足不满意。 尽管三关节融合术是晚期AAFD的金标准治疗方法，骨融合率较高，但主要畸形的不完全矫正和残余疼痛的持续存在导致患者对手术结果的失望率较高。
