Yang Zongyu, Liu Fei, Cui Liang, Liu Heda, Zuo Junshui, Liu Lin, Li Sentian
Department of Sports Medicine - Foot and Ankle Surgery, Cangzhou Hospital of Integrated TCM-WM, Cangzhou, Hebei, PR China.
Medicine (Baltimore). 2020 Feb;99(7):e18826. doi: 10.1097/MD.0000000000018826.
To analyze the efficacy of arthrodesis combined with osteotomy applied to subtalar, calcaneocuboid, and talonavicular joints for the treatment of adult rigid flatfoot.This retrospective study included 29 adult patients with rigid flatfoot who underwent triple arthrodesis combined with osteotomy from January 2015 to December 2017. All patients suffered from stage III of adult acquired flatfoot. Patients returned for a clinical and radiologic follow-up evaluation at an average of 19.5 (range, 15-27) months postoperatively. Outcomes were assessed by comparing pre- and postoperative AOFAS scores, VAS pain scores, and Karlsson scores, and the radiographic assessment including Meary, Pitch, and Kite angles.Twenty six patients returned for final evaluation. Twenty four patients had an excellent or good outcome on patient subjective self-assessment. All the VAS scores, AOFAS scores, and Karlsson scores at final follow-up showed different extents of improvement. The mean Meary angle significantly decreased from 25.8 ± 5.4 degrees preoperatively to 6.9 ± 7.7 degrees at final follow-up, and the mean Pitch angle improved markedly from 12.5 ± 3.7 points preoperatively to 23.2 ± 4.1 points at final follow-up (P < .001).Arthrodesis combined with osteotomy can effectively correct calcaneal valgus deformity, restore arch structure, and relieve foot pain in adult rigid flatfoot.
分析距下关节、跟骰关节和舟楔关节融合术联合截骨术治疗成人僵硬性平足的疗效。这项回顾性研究纳入了29例2015年1月至2017年12月期间接受三关节融合术联合截骨术的成人僵硬性平足患者。所有患者均为成人获得性平足Ⅲ期。患者术后平均19.5（范围15 - 27）个月返回进行临床和影像学随访评估。通过比较术前和术后的美国足踝外科协会（AOFAS）评分、视觉模拟评分法（VAS）疼痛评分和卡尔森评分，以及包括梅里角（Meary）、坡角（Pitch）和凯氏角（Kite）在内的影像学评估来评估结果。26例患者返回进行最终评估。24例患者在患者主观自我评估中获得优良结果。最终随访时所有VAS评分、AOFAS评分和卡尔森评分均有不同程度改善。平均梅里角术前从25.8±5.4度显著降至最终随访时的6.9±7.7度，平均坡角从术前的12.5±3.7分显著改善至最终随访时的23.2±4.1分（P < 0.001）。融合术联合截骨术可有效矫正成人僵硬性平足的跟骨外翻畸形，恢复足弓结构并缓解足部疼痛。
