文章简介

出版社:Foot Ankle Int.

作   者:Conti et al.

编   号:10.1177/1071100715576918

年   份:2015    点击量:698

文章摘要

BACKGROUND:

While previous work has demonstrated a linear relationship between the amount of medializing calcaneal osteotomy (MCO) and the change in radiographic hindfoot alignment following reconstruction, an ideal postoperative hindfoot alignment has yet to be reported. The aim of this study was to identify an optimal postoperative hindfoot alignment by correlating radiographic alignment with patient outcomes.

背景

尽管已有研究表明,重建后跟骨内移截骨术(MCO)的量和放射线后足校准变化之间呈线性关系,但是较为理想的术后后足校准尚未被报道。本研究的目的是通过将放射线校准与患者预后相关联,从而确定术后最佳的后足校准。

 

METHODS:

Fifty-five feet in 55 patients underwent flatfoot reconstruction for stage II adult-acquired flatfoot deformity (AAFD) by 2 fellowship-trained foot and ankle orthopedic surgeons. Hindfoot alignment was determined as previously described by Saltzman and el-Khoury.24 Changes in pre- and postoperative scores in each Foot and Ankle Outcome Score (FAOS) subscale were calculated for patients in postoperative hindfoot valgus (≥0 mm valgus, n = 18), mild varus (>0 to 5 mm varus, n = 17), and moderate varus (>5 mm varus, n = 20). Analysis of variance and post hoc Tukey's tests were used to compare the change in FAOS results between these 3 groups.

方法

选取55例II期成人获得性扁平足畸形(AAFD)患者的55只脚,由2名经过会员培训过的足踝矫形外科医生对其进行扁平足重建。后足校准由Saltzman和el-Khoury的先前描述来决定。在每一项足踝疗效评分(FAOS)分量表中,对术前和术后评分的24项变化进行计分,将患者分别统计为术后后足外翻(外翻≥0 mm,n =18),轻度内翻(0<内翻< 5 mm,n=17)以及中度内翻(内翻 >5 mm,n =20)。用方差分析和Tukey事后检验法比较这3组FAOS结果的改变。

 

RESULTS:

At 22 months or more postoperatively, patients corrected to mild hindfoot varus showed a significantly greater improvement in the FAOS Pain subscale compared with patients in valgus (P = .04) and the Symptoms subscale compared with patients in moderate varus (P = .03). Although mild hindfoot varus did not differ significantly from moderate varus or valgus in the other subscales, mild hindfoot varus did not perform worse than these alignments in any FAOS subscale. No statistically significant correlations between intraoperative MCO slide distances and FAOS subscales were found.

结果

术后22个月或者更久,与外翻患者相比,轻度后足内翻矫正的患者的FAOS疼痛量表显示明显改善(P =.04);与中度内翻患者相比,其FAOS症状量表也明显改善(P=.03)。在其他量表中,尽管轻度后足内翻与中度内翻或外翻没有明显差异,但是轻度后足内翻在任何FAOS量表中并不比这些校准差。研究发现,术中MCO滑动距离和FAOS量表之间无显著统计学相关性。

 

CONCLUSIONS:

Our study indicates that correction of hindfoot alignment to between 0 and 5 mm of varus on the hindfoot alignment view (clinically a straight heel) following stage II flatfoot reconstruction was associated with the greatest improvement in clinical outcomes following hindfoot reconstruction in stage II AAFD.

结论

我们的研究表明,II期扁平足重建后,在后足校准视图(临床为直脚跟)上,内翻0-5 mm之间的后足校准的矫正与II期AAFD后足重建后临床预后最大程度上的改善相关联。

 

 

由MediCool医库软件 医学编辑 余娟 编译

原文来自:Foot Ankle Int.