Vreden Russian Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, St. Petersburg, Russia; Department of General Surgery, St. Petersburg State University, St. Petersburg, Russia.
Vreden Russian Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, St. Petersburg, Russia.
J Foot Ankle Surg. 2021 Sep-Oct;60(5):973-982. doi: 10.1053/j.jfas.2021.04.010. Epub 2021 Apr 14.
The aim of the study was to test a novel planning method for simultaneous midfoot and hindfoot deformity correction, based on reference lines and angles (RLA) of the talus, calcaneus and first metatarsal in 64 normal radiographs from 55 patients. Talus Joint Line (TJL), from the border of the articular surface of the talus and the posterior process of talus, and mechanical axis of the first metatarsal form the mechanical Lateral Talometatarsal Angle (mLTMA) = 23.6º (±3.2). The length of the first metatarsal line was measured from its intersections with the TJL and first metatarsal head and it was 4.3 (±0.94) times longer that TJL (k). For hindfoot correction planning, we used an axis of the calcaneus formed by a line starting at the middle of the back of the calcaneal tuberosity and going perpendicular to a line from the top point to the bottom point of the calcaneal tuberosity. The intersection of the calcaneal line and the anterior continuation of TJL form the lateral heel angle (LHA) = 15.2º (±3.4).The following parameters were identified: the length from the intersection point of the lines and anterior point of TJL was 2.56 ± 1.1 longer than TJL (k1). The length from the intersection point and posterior border of the calcaneus was 4.59 ± 1.0 times longer than TJL (k2). Planning using the new method was demonstrated and confirmed on 3 case examples. A novel method for analysis and planning of midfoot and hindfoot sagittal plane deformity correction may be used separately or simultaneously for complex deformity correction.
本研究旨在测试一种新的规划方法，用于基于 55 名患者 64 张正常 X 光片的距骨、跟骨和第一跖骨的参考线和角度（RLA）同时矫正中足和后足畸形。距骨关节线（TJL）从距骨关节面的边界和距骨后突开始，与第一跖骨的机械轴形成机械外侧距骨跖骨角（mLTMA）=23.6°（±3.2）。第一跖骨线的长度从其与 TJL 和第一跖骨头的交点测量，它是 TJL（k）的 4.3（±0.94）倍长。对于后足矫正规划，我们使用由跟骨结节背面中间开始并垂直于跟骨结节顶部到底部的线形成的跟骨轴。跟骨线与 TJL 前续的交点形成外侧跟骨角（LHA）=15.2°（±3.4）。确定了以下参数：从线和 TJL 前交点到前点的长度比 TJL 长 2.56±1.1（k1）。从交点到跟骨后缘的长度比 TJL 长 4.59±1.0 倍（k2）。新方法的规划在 3 个病例中进行了演示和验证。一种新的中足和后足矢状面畸形矫正分析和规划方法可单独或同时用于复杂畸形矫正。
