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外侧开放楔形跟骨截骨术联合骨移植增强治疗成人获得性扁平足畸形。临床和影像学结果。

Lateral open wedge calcaneus osteotomy with bony allograft augmentation in adult acquired flatfoot deformity. Clinical and radiological results.

机构信息

Orthopaedic Clinic, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy.

Department of Surgical Sciences (DISC), Università degli Studi di Genova, Viale Benedetto XV, 6, 16132, Genova, Italy.

出版信息

Eur J Orthop Surg Traumatol. 2021 Oct;31(7):1395-1402. doi: 10.1007/s00590-021-02888-3. Epub 2021 Feb 12.

Abstract

The aim of this study is to evaluate the results of patients underwent lateral open wedge calcaneus osteotomy with bony allograft augmentation combined with tibialis posterior and tibialis anterior tenodesis. Twenty-two patients underwent adult-acquired flatfoot deformity were retrospectively evaluated with a minimum 2-year follow-up. Radiographic preoperative and final comparison of tibio-calcaneal angle, talo-first metatarsal and calcaneal pitch angles have been performed. The Visual Analog Scale, American Orthopedic Foot and Ankle Score, the Foot and Ankle Disability Index and the Foot and Ankle Ability Measure were used for subjective and functional assessment. The instrumental range of motion has been also assessed at latest follow-up evaluation and compared with preoperative value. There was a significant improvement of final mean values of clinical scores (p < 0.001). Nineteen out of 22 (86.4%) patients resulted very satisfied or satisfied for the clinical result. There was a significant improvement of the radiographic parameters (p < 0.001). There were no differences between preoperative and final values of range of motion. One failure occurred 7 years after surgery. Adult-acquired flatfoot deformity correction demonstrated good mid-term results and low recurrence and complications rate. LEVEL OF EVIDENCE: Level 4, retrospective case series.

摘要

本研究旨在评估外侧开放楔形跟骨截骨术联合骨同种异体移植物增强与后胫前肌和前胫前肌吻合术治疗患者的结果。回顾性评估了 22 例成人获得性扁平足畸形患者,随访时间至少 2 年。比较了术前和最终的胫距角、距骨第一跖骨和跟骨倾斜角的影像学。使用视觉模拟评分、美国骨科足踝评分、足踝残疾指数和足踝能力测量表进行主观和功能评估。在最近的随访评估中还评估了仪器运动范围,并与术前值进行了比较。临床评分的最终平均值有显著改善(p<0.001)。22 例患者中有 19 例(86.4%)对临床结果非常满意或满意。影像学参数有显著改善(p<0.001)。运动范围的术前值与最终值之间无差异。1 例患者在术后 7 年出现失败。成人获得性扁平足畸形矫正显示出良好的中期结果和低复发率及并发症率。证据水平:4 级,回顾性病例系列。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a30/8448706/36ac032f82fe/590_2021_2888_Fig1_HTML.jpg

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