Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, Rua Cerro Corá, 585, São Paulo, SP, CEP 05061-150, Brazil.
Department of Orthopaedics and Traumatology, Prevent Senior, São Paulo, Brazil.
Int Orthop. 2021 Sep;45(9):2375-2381. doi: 10.1007/s00264-021-05057-7. Epub 2021 May 8.
Hindfoot arthrodesis is used in patients with advanced-stage acquired flatfoot, usually associated with degenerative joint disease. The objective of the present study was to evaluate the clinical and radiographic results of hindfoot arthrodesis using the single-incision medial approach.
A case series of 18 consecutive patients undergoing surgical correction between 2015 and 2018 with hindfoot arthrodesis using the medial approach was evaluated. The clinical assessment used the visual analog pain scale, AOFAS hindfoot score, SF-36, and foot function index. Radiographs and personal satisfaction criteria were also analyzed.
All radiographic parameters evaluated showed a significant improvement (p < .05), except the calcaneal pitch. Pain decreased by 5.1 points (p < .001), and the mean final AOFAS score was 72.6. In three feet, a new surgery was required. Two feet developed talar necrosis. None of the cases presented surgical wound dehiscence, and two presented with superficial infection, which was resolved with the use of oral antibiotics.
Double arthrodesis (subtalar and talonavicular) to correct adult-acquired valgus flatfoot using a medial approach has a low risk of soft tissue complications and presents satisfactory functional results. Avascular necrosis is a serious complication that was present in 11% of cases.
距下关节融合术用于晚期获得性扁平足患者，通常与退行性关节病有关。本研究的目的是评估单切口内侧入路距下关节融合术的临床和影像学结果。
对 2015 年至 2018 年间采用内侧入路行距下关节融合术的 18 例连续患者进行了病例系列研究。临床评估采用视觉模拟疼痛量表、AOFAS 后足评分、SF-36 和足部功能指数。还分析了影像学参数和个人满意度标准。
除跟骨倾斜角外，所有评估的影像学参数均显示出显著改善（p<.05）。疼痛减轻了 5.1 分（p<.001），最终 AOFAS 评分平均为 72.6。有 3 只脚需要再次手术，2 只脚发生距骨坏死。没有病例出现手术切口裂开，有 2 例出现浅表感染，经口服抗生素治疗后得到解决。
采用内侧入路行双关节融合术（距下关节和跟舟关节）矫正成人获得性外翻性平足，软组织并发症风险低，功能结果满意。发生了 11%的病例出现了严重的并发症——股骨头坏死。
