Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey.
Foot Ankle Int. 2022 Oct;43(10):1346-1353. doi: 10.1177/10711007221104076. Epub 2022 Jun 14.
Arthrogryposis multiplex congenita (AMC) is one of the causes of rigid and resistant clubfoot. Talectomy is considered as a primary or salvage procedure for recurrent equinovarus deformity in these patients. We conducted this study to assess patients with AMC who underwent talectomy for the correction of foot and ankle deformities in terms of health-related quality of life and disability.
Patients under 10 years of age with a primary diagnosis of AMC who underwent talectomy and attended follow-up for at least 5 years were included in this study. We also formed an age- and gender-matched control group consisting of 20 individuals without any foot-ankle problem in order to compare the measurements between the AMC and healthy groups. Oxford Ankle Foot Questionnaire (OxAFQ) was administered as a health-related quality of life instrument to objectively measure the disability of the pediatric patients.
Twenty patients (10 girls, 10 boys) who underwent a total of 35 talectomy operations with an average follow-up of 7.2 years and a control group of 20 similarly aged unaffected children were included in the study. The mean OxAFQ scores were significantly lower in the AMC group than in the controls for all domains (physical, emotional, and school and play), especially for the one concerning satisfaction with footwear The presence of plantigrade foot and absence of forefoot supination were significantly associated with the physical and footwear domains of the OxAFQ scores. The presence of hindfoot varus, midfoot adductus, dorsal bunion, and having less than 10 degrees of dorsiflexion had no effect on the OxAFQ scores.
In this study, we found that the major driving factors for satisfaction after talectomy for AMC were plantigrade foot and absence of forefoot supination. The mean OxAFQ scores were universally lower in the AMC group than controls. Finding comfortable footwear is a major concern for the AMC patients.
Level III, retrospective cohort study.
先天性多发性关节挛缩症（AMC）是导致僵硬和难以矫正的马蹄足的原因之一。在这些患者中，跟骨切除术被认为是治疗复发性马蹄内翻畸形的主要或挽救性手术。我们进行这项研究是为了评估接受跟骨切除术治疗足部和踝关节畸形的 AMC 患者的健康相关生活质量和残疾情况。
本研究纳入了年龄在 10 岁以下、初次诊断为 AMC 且接受随访至少 5 年的患者。我们还建立了一个年龄和性别匹配的对照组，由 20 名无足踝问题的个体组成，以比较 AMC 组和健康组之间的测量值。牛津踝关节足问卷（OxAFQ）作为一种健康相关生活质量工具用于客观测量儿科患者的残疾情况。
本研究共纳入 20 例患者（10 名女孩，10 名男孩），共进行了 35 次跟骨切除术，平均随访 7.2 年，并纳入了 20 名年龄相仿、无影响的正常儿童作为对照组。在所有领域（身体、情感和学校和娱乐），尤其是在与鞋子满意度相关的领域，AMC 组的 OxAFQ 评分明显低于对照组。足底平足和无前足旋前与 OxAFQ 评分的身体和鞋子领域显著相关。后足内翻、中足内收、背侧足趾和背屈角度小于 10 度与 OxAFQ 评分无关。
在这项研究中，我们发现，跟骨切除术治疗 AMC 后满意度的主要驱动因素是足底平足和无前足旋前。AMC 组的平均 OxAFQ 评分普遍低于对照组。找到舒适的鞋子是 AMC 患者的主要关注点。
三级，回顾性队列研究。
