Guo Baofeng, Qin Sihe, Jiao Shaofeng, Shi Lei
Orthopaedic Department 2, Beijing Chuiyangliu Hospital, Beijing, 100122, P. R. China.
Department of Orthopaedic Surgery, Rehabilitation Hospital Affiliated to National Research Center for Rehabilitation Technical Aids, Beijing, 100176, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Aug 15;39(8):958-964. doi: 10.7507/1002-1892.202506096.
To explore the effectiveness of QIN Sihe's surgical strategy combined with Ilizarov technique in treating foot and ankle deformities on the verge of amputation.
A retrospective analysis was conducted on the clinical data of 56 patients (62 feet) with foot and ankle deformities on the verge of amputation treated with QIN Sihe's surgical strategy and Ilizarov technique between May 2010 and December 2020. Among them, there were 39 males and 17 females. The age ranged from 8 to 62 years (median, 27.5 years). QIN Sihe's surgical strategy: subcutaneous release or open lengthening of contracted Achilles tendons, limited correction of bony deformities through multiple osteotomies during surgery, tendon transfer to balance the power of the foot and ankle, simultaneous percutaneous osteotomy and correction of tibial torsion deformity to restore the weight-bearing line of the lower extremity, and installation of Ilizarov foot and ankle distraction devices for slow distraction and correction of residual foot and ankle deformities. After removal of external fixation, individualized braces were used for protection during exercise and walking. For patients with bilateral deformities, staged surgeries were performed. The effectiveness was evaluated according to the QIN Sihe's Postoperative Evaluation Criteria for Lower Limb (Foot and Ankle) Deformity Correction and Functional Reconstruction at last follow-up.
All patients achieved the preoperative expected orthopedic and functional reconstruction goals. The postoperative wearing time of external fixator was 3-7 months, with an average of 5.5 months. The incidence of pin tract infection during the treatment period was 6.5% (4/62). All patients were followed up 25-132 months (median, 42 months). All 56 patients successfully retained their limbs. At last follow-up, foot and ankle deformities were corrected, the weight-bearing line was basically restored, and plantigrade feet were restored. At last follow-up, according to QIN Sihe's Postoperative Evaluation Criteria for Lower Limb (Foot and Ankle) Deformity Correction and Functional Reconstruction, the effectiveness was rated as excellent in 37 cases (39 feet), good in 18 cases (21 feet), and fair in 1 case (2 feet). The excellent and good rate was 96.8% (60/62).
The combination of QIN Sihe's surgical strategy and Ilizarov technique in treating foot and ankle deformities on verge of amputation is minimally invasive, safe, and the therapeutic effect is controllable. This combined approach has unique advantages in preserving limb function and restoring biomechanical balance.
探讨秦泗河手术策略联合伊里扎洛夫技术治疗濒临截肢的足踝畸形的疗效。
回顾性分析2010年5月至2020年12月采用秦泗河手术策略联合伊里扎洛夫技术治疗的56例（62足）濒临截肢的足踝畸形患者的临床资料。其中男39例，女17例。年龄8～62岁（中位数27.5岁）。秦泗河手术策略：对挛缩的跟腱进行皮下松解或开放延长，术中通过多次截骨有限矫正骨畸形，肌腱转移以平衡足踝动力，同时经皮截骨并矫正胫骨扭转畸形以恢复下肢负重线，安装伊里扎洛夫足踝牵伸装置进行缓慢牵伸并矫正残留的足踝畸形。拆除外固定后，运动和行走时使用个性化支具保护。双侧畸形患者分期手术。末次随访时根据秦泗河下肢（足踝）畸形矫正与功能重建术后评价标准评估疗效。
所有患者均达到术前预期的矫形和功能重建目标。外固定器术后佩戴时间为3～7个月，平均5.5个月。治疗期间针道感染发生率为6.5%（4/62）。所有患者随访25～132个月（中位数42个月）。56例患者均成功保肢。末次随访时，足踝畸形得到矫正，负重线基本恢复，恢复了平足。末次随访时，根据秦泗河下肢（足踝）畸形矫正与功能重建术后评价标准，疗效评定为优37例（39足），良18例（21足），可1例（2足）。优良率为96.8%（60/62）。
秦泗河手术策略联合伊里扎洛夫技术治疗濒临截肢的足踝畸形具有微创、安全、疗效可控的特点。这种联合方法在保留肢体功能和恢复生物力学平衡方面具有独特优势。
