Abstract：
The optimal extent of arthrodesis for severe and rigid progressive collapsing foot deformity is controversial. Traditionally, triple arthrodesis has been recommended; however, good results have been reported using subtalar arthrodesis only. We compared the results of triple arthrodesis and isolated subtalar repositional arthrodesis. A total of 22 symptomatic feet were evaluated retrospectively. Isolated subtalar repositional arthrodesis was performed in 13 cases (the subtalar group) and double or triple arthrodesis in 9 cases (the triple group). Various radiographic variables for assessing flatfoot and osteoarthritic changes in ankle and tarsal joints were measured and compared between the 2 groups at 3 time points: preoperatively, 3 months postoperatively, and 4 y postoperatively. Additionally, we analyzed various factors that affect postoperative valgus talar tilt in the ankle joint, which has been associated with poor prognosis. There were no differences in preoperative demographic data and the severity of the disease between the 2 groups; both groups showed improvement in radiographic parameters postoperatively compared with preoperative results. With the numbers available, no significant differences could be detected in postoperative radiographic measurements between the 2 groups. Of all the variables analyzed, postoperative hindfoot alignment angle was associated with postoperative talar tilt development. Additionally, postoperative talar tilt was observed more in triple group than in subtalar group. In conclusion, isolated subtalar repositional arthrodesis is an effective procedure to correct advanced progressive collapsing foot deformity. In addition, Chorpart joint arthrodesis with improper position can cause valgus talar tilt in the ankle joint.
摘要：
对于严重和僵硬的进行性塌陷性足部畸形，关节固定术的最佳范围是有争议的。传统上,建议使用三重关节固定术；然而，据报道，仅使用距下关节固定术取得了良好的效果。我们比较了三重关节固定术和孤立的距下复位关节固定术的结果。回顾性评估了总共22只有症状的脚。孤立性距下复位关节固定术13例(距下组)，双或三关节固定术9例(三联组)。在3个时间点测量并比较2组之间评估踝关节扁平足和骨关节炎变化的各种影像学变量：术前，术后3个月,术后4年。此外,我们分析了影响踝关节术后外翻距骨倾斜的各种因素，这与预后不良有关。两组之间的术前人口统计学数据和疾病严重程度没有差异；与术前结果相比，两组术后影像学参数均有所改善。有了可用的数字，两组的术后影像学测量结果无显著差异.在分析的所有变量中，术后后足对齐角度与术后距骨倾斜发展相关。此外,三联组术后距骨倾斜比距下组更多。总之,孤立的距下复位关节固定术是纠正晚期进行性塌陷足畸形的有效方法。此外,位置不当的Chorpart关节固定术可导致踝关节外翻距骨倾斜。
