Iba Kousuke, Yotsuyanagi Takatoshi, Yamashita Ken, Onuma Masahiro, Kitada Ayaka, Ueda Naohiro
Department of Musculoskeletal Anti-aging Medicine (KI), Sapporo Medical University, Sapporo, Japan.
Department of Plastic and Reconstructive Surgery (TY, KY, MO, AK, NU), Sapporo Medical University, Sapporo, Japan.
J Orthop Sci. 2023 Aug 9. doi: 10.1016/j.jos.2023.07.018.
One of most severe clinical problems related to Apert foot anomalies is medial angulation deformities of the great toe as the foot grows.
The patient was a 22-month-old Japanese child with Apert syndrome, who had broad bilateral great toe showing medially angulated deformity. We performed two-stage surgical treatment including distraction of the remarkable narrowing the first inter-metatarsal space using an external distractor device, and the corrective wedge-osteotomy of the first metatarsal with a graft of wedged bone in the reverse direction and inter-positioning of the resected local bone between the first and second metatarsal to preserve the space. At 3 years after surgery, the patient did not have any disturbance of gait and could wear normal shoes without weight-bearing pain, and was satisfied with the appearance of the great toes.
The two-stage surgical method could be an option for surgical treatment of Apert feet.
与Apert足畸形相关的最严重临床问题之一是随着足部生长，大脚趾出现内翻畸形。
该患者为一名22个月大的患有Apert综合征的日本儿童，双侧大脚趾宽阔，呈内翻畸形。我们采用两阶段手术治疗，包括使用外固定牵开器装置牵开显著变窄的第一跖骨间隙，以及对第一跖骨进行楔形截骨矫正，并反向植入楔形骨 graft，将切除的局部骨块置于第一和第二跖骨之间以保留间隙。术后3年，患者步态无任何异常，能穿正常鞋子且无负重疼痛，对大脚趾外观满意。
两阶段手术方法可作为Apert足手术治疗的一种选择。
