Hamel J, Hörterer H, Gottschalk O, Harrasser N, Walther M
Zentrum für Fuß- und Sprunggelenkchirurgie, Schön Klinik München Harlaching, München, Deutschland.
Klinik für Allgemeine‑, Unfall- und Wiederherstellungschirurigie, Klinikum der Universität München, LMU München, München, Deutschland.
Orthopade. 2020 Jun;49(6):531-537. doi: 10.1007/s00132-019-03800-y.
In surgical correction of cavovarus deformity bony hindfoot procedures are required in most cases. For treatment planning X‑rays in two or more planes are usually used. In conventional X‑ray-techniques the hindfoot and ankle joint are presented in a more or less outward rotated position. Moreover, the peritalar complex is not delineated in the most corrected position. Therefore, the frequently used talus-metatarsal-I-angle (Meary angle) cannot be measured correctly. By application of the Coleman block test and additional adjustment of the malrotation in the lateral view, the peritalar complex and ankle joint can be evaluated in the corrected and "hindfoot-centred" position. Also, the frequently seen anterior ankle impingement can be observed precisely. Planning of osteotomies or corrective peritalar fusions is supported thereby. Some treatment examples are presented.
在马蹄内翻畸形的手术矫正中，大多数情况下都需要进行后足骨性手术。在治疗规划中，通常会使用两个或更多平面的X线片。在传统的X线技术中，后足和踝关节或多或少处于向外旋转的位置。此外，距下关节复合体在最矫正的位置并未清晰显示。因此，常用的第一跖骨-距骨角（梅里角）无法准确测量。通过应用科尔曼垫块试验并在侧位视图中进一步调整旋转不良，可以在矫正后的“后足以中心”位置评估距下关节复合体和踝关节。此外，还可以精确观察常见的踝关节前方撞击。这有助于截骨术或矫正性距下关节融合术的规划。文中还给出了一些治疗实例。
