UNASSIGNED: A total of 67 patients with MWD were recruited and divided into two groups according to whether midfoot alignment was reduced: reduction group (n = 38) and malreduction group (n = 29). Demographic characteristics before the operation and at the last follow-up, as well as clinical and radiographic parameters, were compared between the two groups. Clinical parameters included the American Orthopaedic Foot & Ankle Society score and visual analog scale score, whereas radiographic parameters included the calcaneal pitch angle, lateral Meary\'s angle, talometatarsal-1 angle dorsoplantar (TMT1dp), talocalcaneal angle dorsoplantar (Kite angle), talonavicular coverage angle, and medial navicular pole extrusion. Postoperative complications and incidence of midfoot pain were evaluated at the last follow-up visit.
UNASSIGNED: The reduction group exhibited better clinical and radiological parameters, including the TMT1dp and medial navicular pole extrusion, than the malreduction group at the last follow-up (all P < .05). However, the calcaneal pitch angle, lateral Meary\'s angle, Kite angle, and talonavicular coverage angle did not significantly differ between the two groups (all P > .05). The overall incidence of midfoot pain was 26.4%. The reduction group showed a lower incidence of medial pain than the malreduction group (15.7% vs. 40.0%, P < .05). Regression analysis revealed that midfoot abduction, represented by the TMT1dp, was a critical factor for midfoot arthrodesis failure and that medial navicular pole extrusion was not correlated with postoperative midfoot pain.
UNASSIGNED: Midfoot reduction arthrodesis yields better clinical outcomes than malreduction arthrodesis. The TMT1dp, representing midfoot abduction, is a key factor for midfoot arthrodesis failure. The extruded medial navicular bone may not affect postoperative medial midfoot pain.
UNASSIGNED: Level III, retrospective comparative study.
■共纳入67例MWD患者,根据是否减少中足对齐分为两组:减少组(n=38)和减少不良组(n=29)。手术前和最后一次随访时的人口统计特征,以及临床和影像学参数,对两组进行比较。临床参数包括美国骨科足踝协会评分和视觉模拟量表评分,而射线照相参数包括跟骨俯仰角,横向米里角,足趾1角足底(TMT1dp),足趾角(风筝角),距骨覆盖角,和内侧舟骨极挤压。在最后一次随访时评估术后并发症和中足疼痛的发生率。
■减少组表现出更好的临床和放射学参数,包括TMT1dp和内侧舟骨极挤压,末次随访时,不良复位组比较(均P<0.05)。然而,跟骨俯仰角,横向米里角,风筝角度,两组间无显著差异(P均>.05)。中足疼痛的总发生率为26.4%。复位组的内侧疼痛发生率低于复位不良组(15.7%vs.40.0%,P<0.05)。回归分析显示中足外展,以TMT1dp为代表,是中足关节固定术失败的关键因素,内侧舟骨极挤压与术后中足疼痛无关。
■中足减少关节固定术比减少关节固定术产生更好的临床结果。TMT1dp,代表中足绑架,是中足关节固定术失败的关键因素。挤压的内侧舟骨可能不会影响术后内侧中足疼痛。
■三级,回顾性比较研究。