Hospital for Special Surgery, New York, NY, USA.
Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
Foot Ankle Int. 2020 Oct;41(10):1302-1306. doi: 10.1177/1071100720950742. Epub 2020 Aug 27.
There is evidence supporting medial soft tissue reconstruction, such as spring and deltoid ligament reconstructions, in the treatment of severe progressive collapsing foot deformity (PCFD). We recommend spring ligament reconstruction to be considered in addition to lateral column lengthening or subtalar fusion at the initial operation when those procedures have given at least 50% correction but inadequate correction of the severe flexible subluxation of the talonavicular and subtalar joints. We also recommend combined flatfoot reconstruction and deltoid reconstruction be considered as a joint sparing alternative in the presence of PCFD with valgus deformity of the ankle joint if there is 50% or more of the lateral joint space remaining.
Level V, expert opinion.
对于严重进展性塌陷足畸形（PCFD）的治疗，有证据支持内侧软组织重建，如弹簧和三角韧带重建。我们建议在初始手术中，当外侧柱延长或距下关节融合术至少纠正了 50%但严重的距跟和距下关节半脱位未得到充分纠正时，除了进行外侧柱延长或距下关节融合术之外，还应考虑进行弹簧韧带重建。如果外侧关节间隙仍有 50%或更多，且踝关节存在外翻畸形，我们还建议在存在 PCFD 的情况下，将平足重建和三角韧带重建联合作为一种保留关节的替代方案。
V 级，专家意见。
