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成人拇外翻与柔韧性扁平足畸形同时矫正的效果

Outcomes of Simultaneous Correction of Adult Hallux Valgus and Flexible Pes Planus Deformities.

作者信息

Gu Wenqi, Fu Shaoling, Wang Changbao, Song Guoxun, Shi Zhongmin, Zhang Hongtao

出版信息

Orthopedics. 2025 Jan-Feb;48(1):37-43. doi: 10.3928/01477447-20241213-03. Epub 2024 Dec 17.

Abstract

BACKGROUND

There is a high correlation between hallux valgus and pes planus deformity. We sought to evaluate the outcomes of simultaneous Scarf osteotomy and extraosseous talotarsal stabilization (EOTTS) for correcting adult hallux valgus with flexible pes planus deformity.

MATERIALS AND METHODS

This retrospective study enrolled patients who had hallux valgus deformity with flexible pes planus and underwent combined Scarf osteotomy and EOTTS from January 2018 to October 2021. The hallux valgus angle (HVA), intermetatarsal angle (IMA), Meary's angle, calcaneal pitch, and lateral talocalcaneal angles were assessed preoperatively and at 1-year follow-up. Clinical outcomes were evaluated using the visual analog scale (VAS) score for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, and the Maryland foot score (MFS). Complications were recorded.

RESULTS

This study included 25 patients, 19 women and 6 men, with a mean age of 44.3 years. The mean follow-up period was 14.6 months. The mean HVA, IMA, Meary's angle, calcaneal pitch, and lateral talocalcaneal angles improved significantly at 1-year follow-up (<.001). The mean VAS score decreased from 5.8 to 1.0, whereas the mean AOFAS forefoot score and MFS increased from 52.3 to 88.9 and 61.2 to 89.3, respectively, at 1-year follow-up (<.001). Two patients had arthroereisis implant removal as a consequence of sinus tarsi pain. No other complications were seen during the follow-up.

CONCLUSION

Management of hallux valgus with flexible pes planus deformity with combined Scarf osteotomy and EOTTS can achieve satisfactory clinical and radiologic results with low complication and recurrence rates. [ 2025;48(1):37-43.].

摘要

背景

拇外翻与扁平足畸形之间存在高度相关性。我们旨在评估同时进行Scarf截骨术和距下关节外稳定术(EOTTS)矫正成人拇外翻合并柔韧性扁平足畸形的效果。

材料与方法

这项回顾性研究纳入了2018年1月至2021年10月期间患有拇外翻畸形合并柔韧性扁平足并接受联合Scarf截骨术和EOTTS的患者。术前及术后1年随访时评估拇外翻角(HVA)、跖间角(IMA)、Meary角、跟骨倾斜度和距下外侧角。使用视觉模拟量表(VAS)疼痛评分、美国矫形足踝协会(AOFAS)前足评分和马里兰足部评分(MFS)评估临床结果。记录并发症情况。

结果

本研究包括25例患者,其中女性19例,男性6例平均年龄44.3岁。平均随访期为14.6个月。术后1年随访时,平均HVA、IMA、Meary角、跟骨倾斜度和距下外侧角均有显著改善(P<0.001)。平均VAS评分从5.8降至1.0,而平均AOFAS前足评分和MFS在术后1年随访时分别从52.3升至88.9和从61.2升至89.3(P<0.001)。2例患者因跗骨窦疼痛取出了关节制动植入物。随访期间未发现其他并发症。

结论

采用联合Scarf截骨术和EOTTS治疗拇外翻合并柔韧性扁平足畸形可取得满意的临床及影像学效果,并发症和复发率低。[2025;48(1):37-43.]

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