Scarf不同截骨角度对平足矫形的影响  

Effect of different Scarf osteotomy angles on orthopedic surgery for flat foot

作　　者：张兴飞 周建东 王文成 张宇轩 田建 许亚军 Zhang Xingfei;Zhou Jiandong;Wang Wencheng;Zhang Yuxuan;Tian Jian;Xu Yajun(Department of Foot and Ankle Surgery,Wuxi Ninth People’s Hospital Affiliated to Soochow University,Wuxi 214000,Jiangsu Province,China)

机构地区：[1]苏州大学附属无锡市第九人民医院足踝外科,江苏省无锡市214000

出　　处：《中国组织工程研究》2023年第29期4670-4676,共7页Chinese Journal of Tissue Engineering Research

基　　金：无锡市卫生健康委科研面上项目(MS201902),项目负责人:许亚军;无锡市科学技术协会软科学研究课题(KX-20-C141),项目负责人:张兴飞。

摘　　要：背景:Scarf截骨术是纠正扁平足外翻的常用方法,是一种三维立体的矫形技术,截骨角度是否会影响矫形力度需要研究明确。目的:在3-matic软件中进行不同角度的Scarf截骨模拟,分析Scarf截骨角度对于扁平足矫形的影响。方法:将平足负重状态的三维骨骼模型导入3-matic软件,得到足部正侧位及后足冠状位草图,测量平足相关指标,作为术前指标。在同一模型上分别进行传统的Evans联合跟骨内移截骨术以及不同角度的Scarf截骨术(45°,60°,75°,90°,105°,120°),截骨完成后再次测量平足相关指标,与术前进行对比分析。结果与结论:单纯的骨性手术对于距骨倾斜角、侧位距骨第1跖骨角无明显影响;Evans术式对于前足外展矫正力度较大,Scarf截骨术对于前足外展无明显影响;对于后足外翻的矫正,Scarf截骨术矫正力度大于传统的Evans联合跟骨内移截骨术式;Scarf截骨术的截骨端接触面积大于Evans联合跟骨内移截骨术,并且随着Scarf截骨角度的增大而逐渐减小。另外,研究还发现,垂直于跟骨外侧壁截骨后,沿垂直于跟骨外侧壁方向内移可起到部分加深足弓的作用。BACKGROUND:Scarf osteotomy is an effective procedure for correcting the valgus of the flat foot,which is a three-dimensional orthopedic procedure.Whether the angle of the osteotomy will affect the orthopedic strength needs to be studied.OBJECTIVE:To simulate Scarf osteotomy at different angles in 3-matic software,and to analyze the effect of Scarf osteotomy angle on flat foot orthopedics.METHODS:Three-dimensional models of the flat foot on weight-bearing state were imported into 3-matic software to obtain the sketches of the frontal lateral and coronal rear foot.The relevant indexes of flat feet were measured as the flat feet indexes before operation.In the same model,the traditional Evans combined with medial displacement calcaneal osteotomy,as well as different angles of Scarf osteotomy,such as 45°,60°,75°,90°,105°,120°were performed.After the osteotomy was completed,the flat foot-related indicators were measured again,and compared with those before the operation.RESULTS AND CONCLUSION:Simple bone surgery had little effect on the talus pitch angle and the talo-first metatarsal angle on lateral side.Evans operation had greater correction of fore foot abduction,while Scarf osteotomy had no significant effect on it.For the effect on the hind foot valgus,Scarf osteotomy showed greater effects than the traditional Evans combined with medial displacement calcaneal osteotomy.The contact area of the osteotomy was larger than that of the traditional one,and decreased gradually with the increase of the angle of Scarf osteotomy.In addition,this study found that perpendicular to the lateral wall of the opposite bone after osteotomy,along the perpendicular to the lateral wall of the external bone can play a part in the role of deepening the arch.

关 键 词：平足 负重三维模型 Scarf截骨 Evans联合MDCO截骨 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687.31