Academic Training Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. Electronic address: https://twitter.com/matthew_conti.
Foot and Ankle Service, Hospital for Special Surgery, 523 East 72nd Street, 5th Floor, New York, NY 10021, USA.
Foot Ankle Clin. 2021 Sep;26(3):591-607. doi: 10.1016/j.fcl.2021.05.005. Epub 2021 Jun 19.
Surgical management of progressive collapsing foot deformity continues to evolve. Previous studies have demonstrated that fusion of the talonavicular joint results in limited hindfoot motion and, therefore, may accelerate adjacent-joint arthrosis. Recent literature has supported using alternative arthrodesis constructs that spare the talonavicular joint, such as naviculocuneiform or isolated subtalar fusions, which may maintain some hindfoot motion through the talonavicular joint yet adequately address a patient's deformity. Concomitant reconstructive procedures may be used in addition to subtalar fusion to address severe deformities. Isolated subtalar fusions may be considered in cases of sinus tarsi or subfibular impingement deformities.
进行性塌陷足畸形的手术治疗仍在不断发展。既往研究表明，距舟关节融合会导致后足活动度受限，从而加速临近关节的骨关节炎。最近的文献支持使用替代的关节融合术式，这些术式保留距舟关节，例如跗舟楔骨或单纯距下关节融合术，这些术式可通过距舟关节维持一定的后足活动度，同时有效解决患者的畸形。为了处理严重的畸形，可以在距下关节融合术的基础上附加其他重建手术。对于跗骨窦或跗骨下撞击畸形，可以考虑单纯距下关节融合术。
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