背景:距下关节病(STA)是小儿柔性扁平足(PFF)的外科干预措施,主要通过限制过度的距下外翻来瞄准后足对齐。然而,它对前足参数的影响仍未充分开发。这项研究旨在调查儿科患者STA后的放射学变化。
方法:对连续使用STA治疗PFF的患者进行回顾性分析。第一个光线相关的角度,包括Hallux外翻角度(HVA)和meta骨间角(IMA),除了后足放射学参数,如Meary,跟骨音高,科斯塔·巴塔尼角,被评估。按性别进行亚组分析,并检查了人口统计学和术前放射学参数之间的相关性。
结果:纳入41例患者(81英尺),平均年龄为11.6岁,平均随访时间为6.4个月。术前和术后第一光线相关角度没有观察到显著差异,平均IMA从7.97°变为7.18°,平均HV角度从9.51°变为8.66°。在平脚角度上看到了值得注意的改进,包括Meary,跟骨音高,科斯塔·巴塔尼角,术后。年龄亚组分析显示,A组(在高峰生长前接受手术)和B组(在高峰生长后接受手术)之间IMA和HVA变化的趋势相似。较高的术前角度趋于改善,而较低的术前IMA和HVA往往会在术后恶化,都在正常范围内。
结论:STA显示PFF治疗的放射学结果为阳性,同时观察到与第一射线相关的角度的变化可忽略不计。年龄亚组分析表明,无论手术时机如何,趋势相似。较高的术前角度趋于改善,虽然较低的术前角度会在术后恶化,尽管都在非病理范围内。需要进一步的研究来证实这种相关性。
BACKGROUND: Subtalar Arthroereisis (STA) is a surgical intervention for pediatric flexible
flatfoot (PFF), primarily targeting hindfoot alignment by limiting excessive subtalar eversion. However, its effects on forefoot parameters remain underexplored. This study aims to investigate radiological changes following STA in pediatric patients.
METHODS: A retrospective analysis was conducted on consecutive patients treated with STA for PFF. First ray-related angles, including the Hallux Valgus Angle (HVA) and the Intermetatarsal Angle (IMA), alongside hindfoot radiological parameters such as the Meary, Calcaneal Pitch, and Costa Bartani angles, were assessed. Subgroup analysis by gender was performed, and correlations between demographic and preoperative radiological parameters were examined.
RESULTS: Forty-one patients (81 feet) with an average age of 11.6 years were included, with a mean follow-up duration of 6.4 months. No significant differences were observed in first ray-related angles pre-and postoperatively, with the mean IMA changing from 7.97° to 7.18° and the mean HV angles changing from 9.51° to 8.66°. Noteworthy improvements were seen in flat foot angles, including the Meary, Calcaneal Pitch, and Costa Bartani angles, postoperatively. The age subgroup analysis revealed similar trends in IMA and HVA changes between Group A (who underwent surgery before peak growth) and Group B (who underwent surgery after peak growth). Higher preoperative angles tended to improve, while lower preoperative IMAs and HVAs tended to worsen postoperatively, all remaining within normal ranges.
CONCLUSIONS: STA showed positive radiological outcomes for PFF treatment, while negligible changes in first ray-related angles were observed. The age subgroup analysis indicated similar trends regardless of operation timing. Higher preoperative angles tended to improve, while lower preoperative angles tended to worsen postoperatively, despite all falling within non-pathological ranges. Further research is warranted to confirm this correlation.