Mann R A, Beaman D N, Horton G A
Foot Fellowship Program, San Leandro, California, USA.
Foot Ankle Int. 1998 Aug;19(8):511-9. doi: 10.1177/107110079801900802.
Forty-eight isolated subtalar arthrodeses in 44 patients with an average follow-up of 59.5 months were retrospectively reviewed. Original diagnoses included talocalcaneal coalition, healed calcaneal fracture with subtalar arthrosis, acquired flatfoot because of posterior tibial tendon dysfunction, degenerative subtalar arthrosis, subtalar instability, and psoriatic arthritis. Ninety-three percent of patients were very satisfied or satisfied with their treatment. Pain and function improved significantly, and the American Orthopaedic Foot and Ankle Society ankle-hindfoot score at follow-up was 89. There were six unsatisfactory results: three feet had calcaneal fractures and three were malpositioned. Union was achieved in all cases. Transverse tarsal motion was diminished by 40%, dorsiflexion by 30%, and plantarflexion by 9%. There was a 36% and 41% incidence of mild radiographic progression of arthrosis in the ankle and transverse tarsal joint, respectively. Isolated subtalar arthrodesis provided a highly successful result in the disease presented, and this study provides support for the use of a selected hindfoot fusion procedure for specific indications.
回顾性分析了44例患者的48例单纯距下关节融合术，平均随访59.5个月。最初诊断包括距跟联合、跟骨骨折愈合伴距下关节病、胫后肌腱功能障碍所致后天性平足、退行性距下关节病、距下关节不稳和银屑病关节炎。93%的患者对其治疗非常满意或满意。疼痛和功能显著改善，随访时美国矫形足踝协会踝后足评分为89分。有6例结果不满意：3例足部有跟骨骨折，3例位置不佳。所有病例均实现了融合。跗横关节活动度减少40%，背屈减少30%，跖屈减少9%。踝关节和跗横关节轻度影像学关节病进展的发生率分别为36%和41%。单纯距下关节融合术在所述疾病中取得了非常成功的结果，本研究为针对特定适应症采用选定的后足融合手术提供了支持。
