Zang Jiancheng, Pan Xuyue, Cui Yidong, Xiao Li, Wei Fangyuan, Chen Zhaojun, Wang Zhengyi
Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, P. R. China.
"Traditional Chinese Orthopedics and Sports Rehabilitation Intelligentization" Engineering Research Center of Ministry of Education, Beijing, 100029, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Aug 15;39(8):965-973. doi: 10.7507/1002-1892.202505056.
To summarize the clinical characteristics of foot and ankle deformities combined with knee and lower limb deformities and evaluate the advantages, clinical outcomes, and considerations of QIN Sihe's surgical strategy for treating such complex deformities.
Between January 2022 and December 2024, 32 patients with foot and ankle deformities combined with knee and lower limb deformities were enrolled. The cohort included 23 males and 9 females, aged 10-67 years (mean, 41.1 years). The main etiologies included post-polio sequelae (20 cases) and congenital limb deformities (3 cases). Deformities were categorized as follows: equinovarus foot (12 cases), equinus foot (2 cases), equinovalgus foot (3 cases), equinus foot with swan-neck deformity (2 cases), calcaneus foot (5 cases), foot valgus (2 cases), knee flexion deformity (14 cases), genu recurvatum (4 cases), genu varum (3 cases), genu valgum (3 cases), lower limb shortening (3 cases), and lower limb external rotation (6 cases). QIN Sihe's surgical strategies included osteotomies, tendon releases, and tendon transfers for deformity correction, followed by external fixation for residual deformity adjustment and stabilization. Outcomes were assessed using QIN Sihe's Postoperative Evaluation Criteria for Lower Limb (Foot and Ankle) Deformity Correction and Functional Reconstruction.
All patients were followed up 8-32 months (mean, 16.5 months). Complications included pin tract infection (1 case, 1 site), ankle pain (2 cases), delayed healing at the proximal tibial osteotomy site (1 case), and anterior talar dislocation (1 case). At last follow-up, insufficient correction of foot deformity was observed in 1 case; both knee and lower limb deformities were corrected, with only mild recurrence of knee flexion deformity in 1 case. The foot/ankle and knee joint function improved. Based on QIN Sihe's Postoperative Evaluation Criteria for Lower Limb (Foot and Ankle) Deformity Correction and Functional Reconstruction, outcomes were rated as excellent in 30 cases and good in 2 cases, with an excellent-good rate of 100%.
Foot and ankle deformities combined with knee and lower limb deformities are complex, QIN Sihe's surgical strategy can achieve satisfactory clinical outcomes for simultaneous correction.
总结足踝畸形合并膝及下肢畸形的临床特点，评价秦泗河治疗此类复杂畸形手术策略的优势、临床疗效及注意事项。
纳入2022年1月至2024年12月期间32例足踝畸形合并膝及下肢畸形患者。该队列包括23例男性和9例女性，年龄10 - 67岁（平均41.1岁）。主要病因包括小儿麻痹后遗症（20例）和先天性肢体畸形（3例）。畸形分类如下：马蹄内翻足（12例）、马蹄足（2例）、马蹄外翻足（3例）、伴有鹅颈畸形的马蹄足（2例）跟行足（5例）、足外翻（2例）、膝关节屈曲畸形（14例）、膝反张（4例）、膝内翻（3例）、膝外翻（3例）、下肢短缩（3例）、下肢外旋（6例）。秦泗河的手术策略包括截骨、肌腱松解和肌腱转位以矫正畸形，随后采用外固定调整和稳定残余畸形。采用秦泗河下肢（足踝）畸形矫正与功能重建术后评价标准评估疗效。
所有患者均获随访8 - 32个月（平均16.5个月）。并发症包括针道感染（1例，1处）、踝关节疼痛（2例）、胫骨近端截骨部位延迟愈合（1例）、距骨前脱位（1例）。末次随访时，1例足畸形矫正不足；膝及下肢畸形均获矫正，仅1例膝关节屈曲畸形有轻度复发。足/踝关节及膝关节功能改善。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30例，良2例，优良率为100%。
足踝畸形合并膝及下肢畸形较为复杂，秦泗河的手术策略可实现满意的同期矫正临床疗效。
