背景:特发性柔性扁平足是儿童的常见病,通常随着年龄的增长而改善,并且无症状。然而,情况有时会更严重,并导致机械性损伤或疼痛。该研究的目的是进行前瞻性临床,放射学,距骨下钛螺钉关节的内镜和纤维造影评估(静态和动态),用于对症治疗,特发性,灵活的平脚。
方法:前瞻性,连续的,非受控,队列,进行临床随访研究.总的来说,30名患者(41英尺),平均年龄10岁(6至16岁),进行了评估。临床和常备放射学评估,静态和动态pedobarography,以及后镜检查,在手术前和最终随访时进行。
结果:治疗与足跟外翻角度的显著改善有关,影像学参数(外侧和背平面距骨第一跖骨角,跟骨倾角,距骨偏角,纵向拱角)和后视参数(克拉克角,Staheli的拱门指数和Chippaux-Smirak指数)。侧向载荷显著增加,前脚接触阶段和双支撑/摆动阶段,和减少的内侧负荷(动态pedobography),以及外侧中足面积和装载,但在前足内侧负荷(静态足月造影)下观察到下降。4例患者报告了关节窦区持续疼痛(6英尺),在一个案例中,由于矫正不足,植入物被替换为较大的植入物。研究组未出现过度矫正或感染并发症。
结论:距下关节是一种治疗对症的微创和有效的手术方法,特发性,灵活的平足;它具有可接受的并发症发生率,早期临床效果良好。
方法:IIb.
BACKGROUND: Idiopathic flexible flatfoot is a common condition in children which typically improves with age and remains asymptomatic. However, the condition can sometimes be more severe, and cause mechanical impairment or pain. The aim of the study was to perform a prospective clinical, radiological, podoscopic and pedobarographic assessment (static and dynamic) of subtalar titanium screw arthroereisis for the treatment of symptomatic, idiopathic, flexible
flatfeet.
METHODS: A prospective, consecutive, non-controlled, cohort, clinical follow-up study was performed. In total, 30 patients (41 feet), mean age 10 (6 to 16 years), were evaluated. Clinical and standing radiological assessments, static and dynamic pedobarography, as well as podoscopy, were performed before surgery and at final follow-up.
RESULTS: Treatment was associated with significant improvements in heel valgus angle, radiographic parameters (lateral and dorso-planar talo-first metatarsal angle, calcaneal inclination angle, talar declination angle, longitudinal arch angle) and podoscopic parameters (Clark\'s angle, Staheli\'s arch index and Chippaux-Smirak index). Significant increases were noted for lateral loading, forefoot contact phase and double support / swing phase, and reduced medial loading (dynamic pedobarography), as well as lateral midfoot area and loading, but decreased were observed for medial forefoot loading (static pedobarography). Four patients reported persistent pain in the sinus tarsi region (six feet), and in one case, the implant was replaced for a larger one due to undercorrection. No overcorrections or infection complications were noted in the study group.
CONCLUSIONS: Subtalar arthroereisis is a minimally-invasive and effective surgical method for treating symptomatic, idiopathic, flexible
flatfeet; it has an acceptable complication rate with good early clinical results.
METHODS: II b.