Heywood A W
Clin Orthop Relat Res. 1983 Jul-Aug(177):76-81.
Supracondylar osteotomy is an alternative to other procedures for realignment of the rheumatoid hindfoot. Of 64 hindfoot operations performed since 1964, 12 were supracondylar osteotomies. The specific indication for this procedure was an ankylosed rheumatoid foot with equinovarus deformity and limited range of tarsal motion. Conventional triple arthrodesis in such circumstances creates a rigid foot, further compromising an already damaged ankle. Of the nine feet available for evaluation one to ten years after operation, seven were relieved of pain and two had anterior metatarsalgia from recurrence of equinus deformity. Correction of varus deformity was maintained in all. Ankle motion diminished from a mean of 17 degrees before operation to 7 degrees when reviewed. Five of the eight ankles had bony fusion. Mean rotatory tarsal motion was improved in two and diminished in seven; mean rotation remained constant, at approximately 13 degrees. Whereas ankle joint motion fared badly under the combined onslaught of disease and osteotomy, the preservation of tarsal motion, correction of deformity, and relief of pain make supramalleolar osteotomy a worthwhile alternative procedure under the specific circumstances cited.
髁上截骨术是类风湿性后足关节重新排列的其他手术方法的替代方案。自1964年以来进行的64例后足手术中，有12例为髁上截骨术。该手术的具体适应症为患有马蹄内翻畸形且跗骨活动范围受限的类风湿性强直足。在这种情况下进行传统的三关节融合术会导致足部僵硬，进一步损害本已受损的踝关节。在术后一到十年可进行评估的九只足中，七只疼痛缓解，两只因马蹄畸形复发出现前足跖痛。所有病例的内翻畸形均得到矫正。复查时，踝关节活动度从术前平均17度降至7度。八只踝关节中有五只出现了骨性融合。平均跗骨旋转活动度在两只足中改善，七只足中减小；平均旋转度保持不变，约为13度。尽管在疾病和截骨术的双重影响下踝关节活动度较差，但跗骨活动度的保留、畸形的矫正以及疼痛的缓解使在上述特定情况下进行的踝关节上截骨术成为一种值得采用的替代手术。
