距舟固定弹簧韧带紧缩矫正成人扁平足△

Spring ligament reefing with talonavicular fixation for correction of adult flatfoot

摘要:

[目的] 探讨成人扁平足矫正术中距舟关节固定弹簧韧带紧缩的临床疗效分析。[方法] 回顾性分析 2018 年 1 月— 2021 年 6 月本院收治的 30 例 III 期扁平足患者的临床资料，均行距舟关节固定联合弹簧韧带紧缩术。评价临床及影像结果。 [结果]患者均顺利完成手术，无神经、血管损伤等并发症。随访时间平均（16.7±4.8）个月，与术前相比，术后 12 个月及末次随访时 AOFAS 评分显著增加 [(64.6±3.8), (88.9±2.8), (89.3±2.6), P＜0.001]，VAS 评分显著减少 [(3.0±0.5), (0.2±0.4), (0.2±0.4 ), P＜ 0.001]。影像方面，患足负重位 X 线片 Meary 角 [(18.2±3.4)°, (5.2±2.0)°, (5.3±2.0 )°, P＜0.001] 和 TCA 角 [(23.3±3.0)°, (6.9±1.8)°, (6.8± 1.9 )°, P＜0.001] 显著减少，Pitch 角 [(15.1±2.9)°, (22.9±3.3)°, (22.7±3.3)°, P＜0.001] 显著增加。[结论] 对于 III 期成人扁平足患者， 应用距舟固定联合弹簧韧带紧缩矫正的手术具有较好的临床疗效，术后步态舒适度更高。

Abstract:

[Objective] To investigate the clinical outcomes of spring ligament reefing with talonavicular fixation for correction of adult flatfoot. [Methods] A retrospective study was done on 30 patients who received spring ligament reefing with talonavicular fixation, combined with other traditional procedures if necessary for stage III flatfoot in our hospital from January 2018 to June 2021. Clinical and imaging conse- quences were evaluated. [Results] All the patients were operated on successfully without neurovascular injury and other complications, and followed up for (16.7±4.8) months on an average. Compared with those preoperatively, AOFAS score significantly increased at 12 months postoperatively and the latest follow-up [(64.6±3.8), (88.9±2.8), (89.3±2.6), P＜0.001], while the VAS score for pain significantly reduced [(3.0±0.5), (0.2±0.4), (0.2±0.4), P＜0.001]. Radiographically, the Meary angle on full weight-bearing X ray [(18.2±3.4)°, (5.2±2.0)°, (5.3± 2.0)°, P＜0.001] and TCA angle [(23.3±3.0)°, (6.9±1.8)°, (6.8±1.9)°, P＜0.001] significantly reduced, while the pitch angle [(15.1±2.9)°, (22.9 ± 3.3)° , (22.7 ± 3.3)° , P＜0.001] significantly increased. [Conclusion] The spring ligament reefing with talonavicular fixation does achieve satisfactory clinical outcomes with high comfort postoperative gait for stage III adult flatfoot.