[1]赵廷虎△,陈汉鑫,郑挺渠,等.距下关节制动术治疗成人柔性平足症28例[J].中国中医骨伤科杂志,2023,31(02):70-74.
　ZHAO Tinghu CHEN Hanxin ZHENG Tingqu WU Junlong JIA Bin BAI Yunbo.Efficacy Study of Subtalar Joint Immobilizationon the Treatment of Adult Stage Ⅱ Flat Foot 28 Cases[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(02):70-74.
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距下关节制动术治疗成人柔性平足症28例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年02期
页码:
70-74
栏目:
临床报道
出版日期:
2023-02-15

文章信息/Info

Title:
Efficacy Study of Subtalar Joint Immobilizationon the Treatment of Adult Stage Ⅱ Flat Foot 28 Cases
文章编号:
1005-0205(2023)02-0070-05
作者:
赵廷虎1△; 陈汉鑫1; 郑挺渠1; 武军龙1; 贾斌1; 白云波1
1深圳平乐骨伤科医院(坪山区中医院)足踝外科(广东 深圳,518122)
Author(s):
ZHAO Tinghu1△ CHEN Hanxin1 ZHENG Tingqu1 WU Junlong1 JIA Bin1 BAI Yunbo1
1Shenzhen Pingle Orthopedic Hospital(Pingshan Traditional Chinese Medicine Hospital),Shenzhen 518122,Guangdong China.
关键词:
成人平足症;  距下关节制动术;  临床疗效;  影像学指标;  短期随访
Keywords:
flat foot;  subtalar joint;  short term follow-up;  imaging index;  clinical efficacy
分类号:
R682.6
文献标志码:
B
摘要:
目的:探讨距下关节制动术治疗成人Meryson分型Ⅱ期平足症的短期临床疗效。方法:回顾性分析2018年6月至2020年6月收治的采用距下关节制动术治疗的成年人平足症患者28例,共34足,均为Meryson分型Ⅱa期。其中男17例共22足,女11例共12足; 年龄为21～60岁,平均年龄为(36.15±8.80)岁。术前测量所有患者的足部负重位X线片的Meary角、Pitch角、距骨第三跖骨角、跟骨外翻角、距舟覆盖角(Talonavicular Coverage Angle,TCA),并评估所有患者的美国骨科足踝协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足评分及视觉模拟量表(VAS)评分并予以记录,用来评估影像学指标、足部功能及疼痛。随访末期记录相同观察指标并予以记录,比较各项指标是否与术前有统计学差异。结果:术后所有患者均获随访,随访时间为8～16个月,平均随访时间为(11.60±1.42)个月。术后随访第6个月足部负重位X线片评价正位Meary角为2.82°±1.65°,Pitch角为22.24°±2.60°,侧位Meary角为2.82°±1.63°,距骨第二跖骨角为14.32°±1.25°,跟骨外翻角为4.18°±1.03°,距舟覆盖角为11.59°±1.25°,与术前正位Meary角11.38°±2.76°,Pitch角10.91°±1.68°,侧位Meary角10.61°±2.92°,距骨第二跖骨角27.88°±2.53°,跟骨外翻角9.74°±2.05°,距舟覆盖角21.27°±2.17°差异有统计学学意义(P<0.05)。术后随访第6个月AOFAS评分为(91.80±3.40)分,与术前AOFAS评分(53.50±2.80)分差异有统计学意义(P<0.05)。根据功能评级,优28足,良6足,优良率为100%。术后随访第6个月的VAS评分平均为(1.29±0.81)分,和术前(6.12±0.95)分相比差异有统计学意义(P<0.05)。结论:距下关节制动术治疗成人Meryson分型Ⅱa期平足症,影像学改善明显,短期随访术后足功能好,患者畸形及疼痛改善明显。
Abstract:
Objective:To evaluate the short and medium-term efficacy of subtalar joint immobilization on the treatment of adult stage Ⅱ flat foot.Methods:28 adult patients with flat foot treated by subtalar joint braking in our hospital from June 2018 to June 2020 were retrospectively analyzed with 34 feet in total.All of 34 feet were stage Ⅱa,including 17 males with 22 feet in total and 11 females with 12 feet in total.Age 21 to 60 years old with(36.15±8.80)years old on average.The American Orthopedic Foot and Ankle Society(AOFAS)ankle and hindfoot function score was 69.7±3.9 and the preoperative visual analogue scale(VAS)score was 6.14±0.87.The foot weight-bearing position was recorded at the follow-up of 12 months after operation.The meary angle,pitch angle,the second metatarsal angle of talus,calcaneal valgus angle and talonavicular coverage angle(TCA)were measured on the X-ray film.AOFAS ankle and hindfoot function score and VAS score were used to evaluate the clinical effect.The removal of subtalar joint brake,complications and patients' satisfaction with the operation were analyzed.Results:28 patients(34 feet)were followed up for 8 to 16 months with(11.60±1.42)months on average.The weight-bearing X-ray evaluation of 28 adults with flexible flat feet included positive meary angle 2.82°±1.65°,pitch angle 22.24°±2.60°,lateral meary angle 2.82°±1.63°,second metatarsal angle of talus 14.32°±1.25°,calcaneal valgus angle 4.18°±1.03°,TCA 11.59°±1.25° and preoperative positive meary angle 11.38°±2.76°,pitch angle 10.91°±1.68°,lateral meary angle 10.61°±2.92°,second metatarsal angle of talus 27.88°±2.53°.There was significant difference in calcaneal valgus angle 9.74°±2.05° and TCA 21.27°±2.17°(P<0.05).The average score of AOFAS before operation was 53.50±2.80 and that after operation was 91.80±3.40(P<0.05).According to the functional rating,28 feet are excellent,6 feet are good,and the excellent and good rate is 100%.The average VAS score of postoperative follow-up was 1.29±0.81,which was statistically significant compared with that of preoperative 6.12±0.95(P<0.05).Conclusion:Subtalar joint immobilization on the treatment of adult Ⅱa flat foot has the advantages of simple operation,minimally invasive and less complications.It can effectively correct the flat foot deformity and restore the foot function.

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备注/Memo

备注/Memo:
△通信作者 E-mail:zth0428@163.com
更新日期/Last Update: 2023-02-10