Recordon James, Muir Dawson
Department of Orthopaedic Surgery, Tauranga Hospital, Tauranga, NZ.
J Pediatr Soc North Am. 2024 Feb 5;5(4):779. doi: 10.55275/JPOSNA-2023-779. eCollection 2023 Nov.
Most foot deformities affecting children and adolescents can be managed nonoperatively or with joint-preserving procedures. Severe fixed deformities often require more comprehensive treatment, and triple fusion (arthrodesis) remains an option in these situations. Surgical decision-making in electing for a triple fusion in this age group and in these rare conditions can be difficult. The primary goals of treatment are elimination of pain, correction of the deformity, and maintenance of a plantigrade foot. This review aims to outline those situations where triple fusion is warranted and describe our technique. •Although uncommon and reserved for severe deformity, triple fusion remains a powerful procedure with satisfactory long-term outcomes.•Fusion position is the key technical determinant of a successful outcome.•Robust Internal fixation reduces the rate of nonunion.•Foot growth is maintained in most children who have triple fusion as young as 8 years of age.
大多数影响儿童和青少年的足部畸形可以通过非手术治疗或保留关节的手术来处理。严重的固定畸形通常需要更全面的治疗，在这些情况下，三关节融合术（关节固定术）仍是一种选择。对于这个年龄组以及这些罕见病症选择三关节融合术时，手术决策可能会很困难。治疗的主要目标是消除疼痛、矫正畸形以及维持足底着地的足部形态。本综述旨在概述那些适合进行三关节融合术的情况并描述我们的技术。•尽管不常见且仅用于严重畸形，但三关节融合术仍是一种有效的手术，长期效果令人满意。•融合位置是手术成功的关键技术决定因素。•坚固的内固定可降低不愈合率。•大多数8岁就接受三关节融合术的儿童足部仍会生长。
