PDF(Pubmed)
Abstract：
UNASSIGNED: For the younger, more active patient with flexible symptomatic progressive collapsing foot deformity (PCFD), joint-sparing procedures may be preferred to preserve functional motion. Isolated talonavicular (TN) arthrodesis has been described for treatment of rigid and flexible PCFD for patients that are older and less active whose deformity is still correctable through the TN joint. The purpose of this study was to evaluate radiographic and clinical outcomes in patients with PCFD treated with isolated triplanar correction with a TN joint arthrodesis.
UNASSIGNED: Forty-nine patients (53 feet) with flexible PCFD underwent isolated TN arthrodesis. Weightbearing radiographs were performed pre- and postoperatively, and measurements included lateral talar-first metatarsal angle, calcaneal pitch, TN coverage angle, and the anteroposterior (AP) talar-first metatarsal angle. The Foot and Ankle Ability Measure (FAAM) and Veterans-Rand 12-Item Health Survey (VR-12) scores were also collected.
UNASSIGNED: Thirty-five females and 14 males were evaluated with a mean age of 63 years, at an average follow-up of 41.3 months. Significant improvements were found radiographically. Lateral radiographs demonstrated improvements in lateral talar-first metatarsal angle from 25.2 degrees preoperatively to 9.5 degrees postoperatively (P < .001) and calcaneal pitch from 14.9 degrees preoperatively to 17.5 degrees postoperatively (P < .001). AP radiographs showed the TN coverage angle improving from 35.0 degrees to 4.9 degrees postoperatively (P < .001) and AP talar-first metatarsal angle improving from 17.3 degrees to 5.9 degrees postoperatively (P < .001). Clinical outcomes were improved in the FAAM pain score (48.6 to 39.2, P = .130), FAAM ADL score (53.8 to 69.2, P = .002), FAAM Sport score (29.5 to 40.7, P = .099), and the overall FAAM score (47.7 to 63.1, P = .006). Patient satisfaction with medical care was 85.2/100 postoperatively.
UNASSIGNED: Isolated TN arthrodesis is a viable surgical option for older, lower-demand patients with flexible PCFD. This study demonstrated significant improvements in radiographic alignment and FAAM scores. Comparative studies with other surgical procedures should be performed to determine which is the best technique for older, lower-demand patients with flexible PCFD.
UNASSIGNED: Level III, retrospective cohort study.
UNASSIGNED: Forty-nine patients (53 feet) with flexible PCFD underwent isolated TN arthrodesis. Weightbearing radiographs were performed pre- and postoperatively, and measurements included lateral talar-first metatarsal angle, calcaneal pitch, TN coverage angle, and the anteroposterior (AP) talar-first metatarsal angle. The Foot and Ankle Ability Measure (FAAM) and Veterans-Rand 12-Item Health Survey (VR-12) scores were also collected.
UNASSIGNED: Thirty-five females and 14 males were evaluated with a mean age of 63 years, at an average follow-up of 41.3 months. Significant improvements were found radiographically. Lateral radiographs demonstrated improvements in lateral talar-first metatarsal angle from 25.2 degrees preoperatively to 9.5 degrees postoperatively (P < .001) and calcaneal pitch from 14.9 degrees preoperatively to 17.5 degrees postoperatively (P < .001). AP radiographs showed the TN coverage angle improving from 35.0 degrees to 4.9 degrees postoperatively (P < .001) and AP talar-first metatarsal angle improving from 17.3 degrees to 5.9 degrees postoperatively (P < .001). Clinical outcomes were improved in the FAAM pain score (48.6 to 39.2, P = .130), FAAM ADL score (53.8 to 69.2, P = .002), FAAM Sport score (29.5 to 40.7, P = .099), and the overall FAAM score (47.7 to 63.1, P = .006). Patient satisfaction with medical care was 85.2/100 postoperatively.
UNASSIGNED: Isolated TN arthrodesis is a viable surgical option for older, lower-demand patients with flexible PCFD. This study demonstrated significant improvements in radiographic alignment and FAAM scores. Comparative studies with other surgical procedures should be performed to determine which is the best technique for older, lower-demand patients with flexible PCFD.
UNASSIGNED: Level III, retrospective cohort study.
摘要：
■对于年轻人来说，更活跃的患者，有柔性症状的进行性塌陷性足部畸形（PCFD），关节保留程序可能是优选的，以保持功能运动。已描述了孤立的距骨（TN）关节固定术，用于治疗年龄较大且活动较少的患者的刚性和柔性PCFD，这些患者的畸形仍然可以通过TN关节矫正。这项研究的目的是评估接受TN关节固定术的孤立三平面矫正治疗的PCFD患者的影像学和临床结果。
■49位（53英尺）柔性PCFD患者接受了孤立的TN关节固定术。术前和术后进行负重射线照片，测量包括外侧距骨-第一跖骨角，跟骨螺距,TN覆盖角,和前后距骨-第一跖骨角。还收集了脚和脚踝能力测量（FAAM）和退伍军人兰德12项健康调查（VR-12）得分。
■对35名女性和14名男性进行了评估，平均年龄为63岁，平均随访41.3个月。在影像学上发现了显着改善。侧位X线片显示距骨外侧-第一跖骨角度从术前25.2度改善至术后9.5度(P<.001)，跟骨间距从术前14.9度改善至术后17.5度(P<.001)。APX线照片显示，TN覆盖角从术后35.0度改善至4.9度（P<.001），AP距骨-第一跖骨角从术后17.3度改善至5.9度（P<.001）。FAAM疼痛评分（48.6至39.2，P=0.130）改善了临床结果，FAAMADL评分（53.8至69.2，P=0.002），FAAM运动评分（29.5至40.7，P=.099），和总体FAAM评分（47.7至63.1，P=.006）。术后患者对医疗护理的满意度为85.2/100。
■隔离TN关节固定术是老年人的可行手术选择，柔性PCFD需求较低的患者。这项研究证明了射线照相比对和FAAM评分的显着改善。应与其他外科手术进行比较研究，以确定哪种技术最适合老年人，柔性PCFD需求较低的患者。
■三级,回顾性队列研究。
■49位（53英尺）柔性PCFD患者接受了孤立的TN关节固定术。术前和术后进行负重射线照片，测量包括外侧距骨-第一跖骨角，跟骨螺距,TN覆盖角,和前后距骨-第一跖骨角。还收集了脚和脚踝能力测量（FAAM）和退伍军人兰德12项健康调查（VR-12）得分。
■对35名女性和14名男性进行了评估，平均年龄为63岁，平均随访41.3个月。在影像学上发现了显着改善。侧位X线片显示距骨外侧-第一跖骨角度从术前25.2度改善至术后9.5度(P<.001)，跟骨间距从术前14.9度改善至术后17.5度(P<.001)。APX线照片显示，TN覆盖角从术后35.0度改善至4.9度（P<.001），AP距骨-第一跖骨角从术后17.3度改善至5.9度（P<.001）。FAAM疼痛评分（48.6至39.2，P=0.130）改善了临床结果，FAAMADL评分（53.8至69.2，P=0.002），FAAM运动评分（29.5至40.7，P=.099），和总体FAAM评分（47.7至63.1，P=.006）。术后患者对医疗护理的满意度为85.2/100。
■隔离TN关节固定术是老年人的可行手术选择，柔性PCFD需求较低的患者。这项研究证明了射线照相比对和FAAM评分的显着改善。应与其他外科手术进行比较研究，以确定哪种技术最适合老年人，柔性PCFD需求较低的患者。
■三级,回顾性队列研究。
