Department of Orthopedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan; Orthopaedic Foot and Ankle Center, Shiseikai Daini Hospital, 5-19-1 Kamisoshigaya, Setagaya-ku, Tokyo, 157-8550, Japan.
Department of Orthopedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan; Orthopaedic Foot and Ankle Center, Shiseikai Daini Hospital, 5-19-1 Kamisoshigaya, Setagaya-ku, Tokyo, 157-8550, Japan; Kohno Clinical Medicine Research Institute, 3-3-7, Kitashinagawa, Shinagawa-ku, Tokyo, 140-0001, Japan.
J Orthop Sci. 2022 Mar;27(2):429-434. doi: 10.1016/j.jos.2020.12.018. Epub 2021 Jan 26.
This study aimed to assess how the postoperative medial arch height influenced postoperative patient-reported clinical outcomes after surgery for stage Ⅱ acquired adult flatfoot deformity.
A total of 30 feet of 30 patients (7 males, 23 females) who underwent surgery for stage Ⅱ acquired adult flatfoot deformity and could be followed up for at least 2 years were included. The average age at surgery was 60.0 (standard deviation, 13.0) years, and the average follow-up period was 40 (standard deviation, 15.4) months. Among them, 16 patients underwent lateral column lengthening and 14 patients did not. Patient-reported clinical outcomes were evaluated using the Self-Administered Foot Evaluation Questionnaire. Radiographic alignment was evaluated by the talonavicular coverage angle, lateral talo-1st metatarsal angle, medial cuneiform height, medial cuneiform to 5th metatarsal height, and calcaneal pitch. The correlation between postoperative Self-Administered Foot Evaluation Questionnaire and radiographic alignment was assessed with Pearson's correlation analysis.
Self-Administered Foot Evaluation Questionnaire and radiographic alignment significantly improved postoperatively in all patients (P < 0.0001). In patients with severe deformity who needed lateral column lengthening, lateral talo-1st metatarsal angle was negatively and medial cuneiform to 5th metatarsal height was positively correlated with physical functioning Self-Administered Foot Evaluation Questionnaire subscales (r = -0.56 and 0.55), and medial cuneiform height was positively correlated with physical functioning, social functioning and general health Self-Administered Foot Evaluation Questionnaire subscales (r = 0.70, 0.55 and 0.73, respectively).
Postoperative medial arch height could influence physical functioning, social functioning, and general health in patients with severe stage II adult-acquired flatfoot deformity.
本研究旨在评估术后内侧足弓高度对接受手术治疗的Ⅱ期成人获得性平足畸形患者术后患者报告的临床结局的影响。
共纳入 30 例（7 名男性，23 名女性）接受手术治疗的Ⅱ期成人获得性平足畸形患者，随访至少 2 年。手术时的平均年龄为 60.0（标准差 13.0）岁，平均随访时间为 40（标准差 15.4）个月。其中，16 例患者行外侧柱延长术，14 例患者未行外侧柱延长术。采用自填式足部评估问卷评估患者报告的临床结局。通过距下关节覆盖角、外侧距跟骨-第一跖骨角、内侧楔骨高度、内侧楔骨到第 5 跖骨高度和跟骨倾斜角评估放射学对线。采用 Pearson 相关分析评估术后自填式足部评估问卷与放射学对线之间的相关性。
所有患者术后自填式足部评估问卷和放射学对线均显著改善（P<0.0001）。在需要行外侧柱延长术的严重畸形患者中，外侧距跟骨-第一跖骨角与物理功能自填式足部评估问卷子量表呈负相关（r=-0.56），内侧楔骨到第 5 跖骨高度与物理功能自填式足部评估问卷子量表呈正相关（r=0.55），而内侧楔骨高度与物理功能、社会功能和一般健康自填式足部评估问卷子量表均呈正相关（r=0.70、0.55 和 0.73）。
术后内侧足弓高度可能影响严重Ⅱ期成人获得性平足畸形患者的物理功能、社会功能和一般健康。
