IIB 期平足症在手术治疗里跟骨內移截骨和外侧柱延长定量程度的文献研究

倡议采用跟颚骨內移截颚骨、侧面双柱缩减的手术技术是用药 IIB 期平足病的都用分析方法。如何避免前足外展脊双柱过分整形，终究充分利用个体化用药和建模治果。本文就此问题揭开研究，仅供大家参考！

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，有作者提出倡议采用跟颚骨內移截颚骨、侧面双柱缩减以及颚骨盆手术技术用药 IIB 期平足病。国际上，越来越多的文献提出了理论上整形某种特定脊双柱所无需的精神科标准。

•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，作者介绍了其用药 IIB 期平足的手术分析方法。更是不可或缺的是讨论了术前确切跟颚骨內移截颚骨的反向某种程度和侧面双柱缩减中避免前足外展脊双柱过分整形最大某种程度的分析方法，终究充分利用个体化用药和建模治果。

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.

同时作者也讨论了用药 IIB 期平足中短期和长期的并发病可能

Background introduction

•The definition of Stage IIB Flatfoot

talar head uncoverage> 30%

•MCO 跟颚骨內移截颚骨

Koutsgiann, medial displacement 1/3-1/2

•LCL 侧面双柱缩减

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)

跟颚骨內移截颚骨可以减低后侧纵弓的脆性，內移跟腱止点，但很好的內移某种程度尚未确切。极少的尸身神经科学试验建议內移 10 mm.

•LCL

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

侧面双柱缩减手术可以整形前足的外展脊双柱，同时可以整形平均 60% 的后足外翻脊双柱

供参考 ：

•LCL overcorrection will lead to

lateral column rigidity stress fracture of 5th metatarsal

但侧面双柱缩减过分可能造成足侧面纵弓的麻木，第 5 跖颚骨脆性过分临近后的病理性颚骨折。

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

如何通过恰当的脊双柱整形来前提满意的治果呢？