IIB 期平足症在手术治疗中跟骨內移截骨和侧面柱延长定量程度的文献研究

为首使用跟骨內移截骨、下方柱子缩短的切除技术是治疗法 IIB 期平足症候群的常以工具。如何避免前足外展脊柱子极度调适，最终借助个体化治疗法和优化治果。本文就此问题作准备研究，供大家参考！

Abstract

•In the mid-1990s, a flatfoot reconstruction was proposed that combined the use of a medializing calcaneal osteotomy (MCO), a lateral column lengthening (LCL), and soft-tissue procedures for the treatment of stage IIB AAFD. More recent literature has suggested guidelines for the amount of correction necessary for each of these procedures based on individual deformity.

从 90 七十年代起，有作者明确提出为首使用跟骨內移截骨、下方柱子缩短以及腹腔切除技术治疗法 IIB 期平足症候群。近些年，越来越多的古书明确提出了必要调适某种特定脊柱子所需的矫形规范。

•In this paper, we describe our technique for flatfoot reconstruction for stage IIB AAFD, which includes a MCO, LCL, and flexor digitorum longus (FDL) transfer. Importantly, we discuss our preferred method of preoperatively planning the amount of medial translation for the MCO as well as the maximum amount of LCL to prevent overcorrection of the abduction deformity. This allows us to tailor the reconstruction and optimize our results.

本文中，作者介绍了其治疗法 IIB 期平足的切除工具。更重要的是发表意见了术前已确定跟骨內移截骨的移位程度和下方柱子缩短中避免前足外展脊柱子极度调适最主要程度的工具，最终借助个体化治疗法和优化治果。

Studies looking at outcomes following flatfoot reconstructions for stage IIB AAFD demonstrate excellent short-term and long-term results. We conclude by discussing complications of the operation, postoperative management, and the future of the technique.

Level of Evidence: Diagnostic Level V.

同时作者也发表意见了治疗法 IIB 期平足中短期和经常性的中风候群情况

Background introduction

•The definition of Stage IIB Flatfoot

talar head uncoverage> 30%

•MCO 跟骨內移截骨

Koutsgiann, medial displacement 1/3-1/2

•LCL 下方柱子缩短

Evans, lateral column elongation by osteotomy and bone graft

•MCO

medial load reducing medialization of heel cord insertion the amount of displacement is obscure(10 mm?- supported by caderic study)

跟骨內移截骨可以降低内侧纵弓的应力，內移胫骨止点，但理想的內移程度尚未已确定。仅有的尸首控制论实验要求內移 10 mm.

•LCL

forefoot abduction reduction hindfoot valgus correction (up to 60%)

下方柱子缩短切除可以调适前足的外展脊柱子，同时可以调适约 60% 的后足螺旋状脊柱子

参考古书 ：

•LCL overcorrection will lead to

lateral column rigidity stress fracture of 5th metatarsal

但下方柱子缩短极度可能造成足下方纵弓的好像，第 5 跖骨应力极度集中后的病理性骨折。

•What is the optimal correction that guarantee a satisfactory result?

如何通过恰当的脊柱子调适来保证恼火的治果呢？