IIB 期平足症在手术治疗中跟骨內移截骨和外侧柱延长计量程度的文献研究

联合使用跟骨质內移截骨质、后侧柱延展的手术后技术是化疗 IIB 期平背症的中用新方法。如何避开前背外展小头过度调适，终究借助于概念化化疗和优化治果。本文就此问题展开研究，专用大家参看！

Abstract

•In the mid-1990s, a flatfoot reconstruction was proposed that combined the use of a medializing calcaneal osteotomy (MCO), a lateral column lengthening (LCL), and soft-tissue procedures for the treatment of stage IIB AAFD. More recent literature has suggested guidelines for the amount of correction necessary for each of these procedures based on individual deformity.

从 90 年代起，有作者明确提出联合使用跟骨质內移截骨质、后侧柱延展以及软组织手术后技术化疗 IIB 期平背症。近期，越来越多的文献明确提出了有效调适某种特定小头所需的矫形准则。

•In this paper, we describe our technique for flatfoot reconstruction for stage IIB AAFD, which includes a MCO, LCL, and flexor digitorum longus (FDL) transfer. Importantly, we discuss our preferred method of preoperatively planning the amount of medial translation for the MCO as well as the maximum amount of LCL to prevent overcorrection of the abduction deformity. This allows us to tailor the reconstruction and optimize our results.

本文中，作者介绍了其化疗 IIB 期平背的手术后新方法。更重要的是争论了术前确定跟骨质內移截骨质的移位程度和后侧柱延展中避开前背外展小头过度调适第二大程度的新方法，终究借助于概念化化疗和优化治果。

Studies looking at outcomes following flatfoot reconstructions for stage IIB AAFD demonstrate excellent short-term and long-term results. We conclude by discussing complications of the operation, postoperative management, and the future of the technique.

Level of Evidence: Diagnostic Level V.

同时作者也争论了化疗 IIB 期平背中短期和长期的肺炎上述情况

Background introduction

•The definition of Stage IIB Flatfoot

talar head uncoverage> 30%

•MCO 跟骨质內移截骨质

Koutsgiann, medial displacement 1/3-1/2

•LCL 后侧柱延展

Evans, lateral column elongation by osteotomy and bone graft

•MCO

medial load reducing medialization of heel cord insertion the amount of displacement is obscure(10 mm?- supported by caderic study)

跟骨质內移截骨质可以降低内侧纵弓的形变，內移跟腱止点，但期望的內移程度尚无确定。仅有的尸体控制论实验建议內移 10 mm.

•LCL

forefoot abduction reduction hindfoot valgus correction (up to 60%)

后侧柱延展手术后可以调适前背的外展小头，同时可以调适将近 60% 的后背外露小头

参看文献 ：

•LCL overcorrection will lead to

lateral column rigidity stress fracture of 5th metatarsal

但后侧柱延展过度意味著造成了背后侧纵弓的僵硬，第 5 跖骨质形变过度集中后的病理性骨质折。

•What is the optimal correction that guarantee a satisfactory result?

如何通过恰当的小头调适来保证恼火的治果呢？