성인의 유연성 편평족에 대한 종골 연장술
Calcaneal Lengthening Osteotomy for the Symptomatic Flexible Flatfoot in Adults
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications,calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.
Abstract
Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications,calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.
참고문헌 (19)
- 박종호, "유연성 편평족에 대한 내측 전위 종골 절골술의 단기 추시 결과", 대한족부족관절학회지, 13(2), pp.113~117 (2009), 대한족부족관절학회
- Zaw H, "Operative management options for symptomatic flexible adult acquired flatfoot deformity : a review", Knee Surg Sports Traumatol Arthrosc, 18, pp.135~142 (2010)
- Evans D, "Calcaneo-valgus deformity", J Bone Joint Surg Br, 57, pp.270~278 (1975)
- Hintermann B, "Lengthening of the lateral column and reconstruction of the medial soft tissue for treatment of acquired flatfoot deformity associated with insufficiency of the posterior tibial tendon", Foot Ankle Int, 20, pp.622~629 (1999)
- Richter M, "Lengthening osteotomy of the calcaneus and flexor digitorum longus tendon transfer in flexible flatfoot deformity improves talo-1st metatarsal-Index, clinical outcome and pedographic parameter", Foot Ankle Surg, 19, pp.56~61 (2013)
- Thomas RL, "Preliminary results comparing two methods of lateral column lengthening", Foot Ankle Int, 22, pp.107~119 (2001)
- Feldman NJ, "In situ tibialis posterior to flexor digitorum longus tendon transfer for tibialis posterior tendon dysfunction : a simplified surgical approach with outcome of 11 patients", J Foot Ankle Surg, 40, pp.2~7 (2001)
- Younger AS, "Radiographic assessment of adult flatfoot", Foot Ankle Int, 26, pp.820~825 (2005)
- Thomas JL, "Radiographic values of the adult foot in a standardized population", J Foot Ankle Surg, 45, pp.3~12 (2006)
- Adams SB, Jr., "Calcaneocuboid joint subluxation after calcaneal lengthening for planovalgus foot deformity in children with cerebral palsy", J Pediatr Orthop, 29, pp.170~174 (2009)
- Kellgren JH, "Genetic Factors in Generalized Osteo-Arthrosis", Ann Rheum Dis, 22, pp.237~255 (1963)
- Dinucci KR, "Biomechanical consequences of lateral column lengthening of the calcaneus: Part I. Long plantar ligament strain", J Foot Ankle Surg, 43, pp.10~15 (2004)
- Thordarson DB, "Effect of calcaneal osteotomy and plantar fasciotomy on arch configuration in a flatfoot model", Foot Ankle Int, 19, pp.374~378 (1998)
- Toolan BC, "Early results after distraction arthrodesis of the calcaneocuboid joint in conjunction with stabilization of, and transfer of the flexor digitorum longus tendon to, the midfoot to treat acquired pes planovalgus in adults", J Bone Joint Surg Am, 81, pp.1545~1560 (1999)
- Mosier-LaClair S, "Operative treatment of the difficult stage 2 adult acquired flatfoot deformity", Foot Ankle Clin, 6, pp.95~119 (2001)
- Mann RA, "Rupture of the posterior tibial tendon causing flat foot. Surgical treatment", J Bone Joint Surg Am, 67, pp.556~561 (1985)
- Cooper PS, "Calcaneocuboid joint pressures with lateral column lengthening(Evans)procedure", Foot Ankle Int, 18, pp.199~205 (1997)
- Momberger N, "Calcaneocuboid joint pressure after lateral column lengthening in a cadaveric planovalgus deformity model", Foot Ankle Int, 21, pp.730~735 (2000)
- Phillips GE, "A review of elongation of os calcis for flat feet", J Bone Joint Surg Br, 65, pp.15~18 (1983)