跟骨外侧延长截骨术治疗小儿扁平足

目的 评估跟骨外侧延长截骨术治疗小儿扁平足的疗效.方法 2002年1月至2006年12月共收治扁平足患儿19例,男15例,女14例,手术年龄6～14岁(平均9.6岁),单侧11例,双侧8例,共27足,采用跟骨外侧延长截骨矫形手术治疗,其中11足因伴有跟腱挛缩同时行跟腱延长术,对患足手术前后的临床症状和X线片进行对比分析.结果 本组18例(26足)获随访,随访时间8～26个月(平均16个月),在2～4个月内获得骨性融合.术后疗效:优8足,良15足,中2足,差1足.跟骨倾斜度由术前(9.7±2.1)°增加到(21.9±2.7)°;距骨水平角由(30.3±4.3)°减少到(16.9±4.0)°;距骨第一跖骨角由(22.8±3.4)°减少到(2.4±3.1)°.结论 跟骨外侧延长截骨术的方法可有效地缓解由于小儿扁平足引起的临床症状,保留了距下关节的功能.

Correction of tarsoptosis by lateral calcaneal lengthening osteotomy in Children

Objective To evaluate the effects of lateral calcaneal lengthening osteotomy for tarsoptosis in children.Methods From Jan.2002 to Dec.2006,19 cases(male 15,female 4)of tarsoptosis were treated.These were unilateralin 11 cases and bilateral in 8 cases with a total of 27 feet.The age ranged from 6 to 14 yr with an average of 9.6 yr.All feet were treated with lateral calcaneal lengthening osteotomy.Eleven of these with associated contracture of Achilles tendon received additionally Achilles tendon lengthening procedures.Results Eighteen children(26 feet)were followed-up with an average period of 16 months(8-26month).According to the preoperative and postoperative presentations and X-ray films,the bony unions of osteotomy were achieved 2 to 4 months after operation..The outcome was excellent in 8 feet,good in 15 feet,fair in 2 feet and one poor.The inclination of calcaneus was corrected from(9.7±2.1)°to(21.9±2.7)°.The lateral astragalar horizontal angle was corrected from(30.3±4.3)°to(16.9±4.0)°,while the lateral talo-metatarsal angle was corrected from(22.8±3.4)°to(2.4±3.1)°.Conclusions Lateral calcaneal lengthening osteotomy is an effective method for the treatment of tarsoptosis by alleviating the clinical symptoms and preserving movement of subtalar joint.