距下关节制动术在青少年扁平足患者中的临床疗效分析  

Clinical Efficacy of Subtalar Joint Immobilization in Adolescent Patients with Flat Foot

作　　者：杨华瑞[1] 郭辉福 杨宜[1] 张恒 鲍同柱[1] 寿康全 Yang Huarui;Guo Huifu;Yang Yi;Zhang Heng;Bao Tongzhu;Shou Kangquan(Department of Orthopedics,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]骨科,湖北宜昌443003

出　　处：《巴楚医学》2025年第1期59-64,共6页Bachu Medical Journal

基　　金：湖北省自然科学基金项目(2021CFB488);宜昌市医疗卫生研究项目(A24-2-007)。

摘　　要：目的:探讨距下关节制动术在青少年扁平足患者中的临床疗效。方法:收集2015年1月—2023年1月于宜昌市中心人民医院就诊的14~21岁青少年扁平足患者69例(共84例扁平足),根据治疗方式不同,分为行距下关节制动术的观察组(n=42)和接受跟骨截骨术的对照组(n=27),比较两组患者的临床疗效。结果:术后18个月,与对照组相比,观察组侧位距骨第一跖骨角(Meary角)、跟骨距骨角(Kite角)、距骨第一跖骨角(T1MT)、距骨第二跖骨角(T2MT)、距骨舟骨覆盖角(TNCA)及视觉模拟量表评分[(1.79±0.94)分vs(2.41±1.47)分]均明显降低,跟骨倾斜角(Pitch角)、美国足踝外科协会踝-后足评分显著升高[(84.67±9.00)分vs(80.12±7.53)分](均P<0.05)。结论:与跟骨截骨术相比,距下关节制动术能更好地矫正距下关节在多维平面上的畸形,恢复后足力线,是治疗青少年扁平足简单而有效的方法,临床疗效显著。Objective:To explore the clinical effect of subtalar joint immobilization in adolescent patients with flat foot.Methods:A total of 69 patients(84 flatfeet in total)who presented at Yichang Central People's Hospital from January 2015 to January 2023 were enrolled.Based on different treatment modalities,they were categorized into an observation group(n=42),which underwent subtalar arthroereisis,and a control group(n=27)that received conventional treatment.The clinical outcomes of the two groups were then compared.Results:Eighteen months after the surgery,in comparison with the control group,the lateral talus first metatarsal angle(Meary angle),calcaneus talus angle(Kite angle),talus first metatarsal angle(T1MT),talus second metatarsal angle(T2MT),talus-navicular coverage angle(TNCA),and visual Analogue Scale score[(1.79±0.94)vs(2.41±1.47)]in the observation group were all notably reduced.Meanwhile,the calcaneal inclination angle(Pitch angle)and the American Orthopaedic Foot and Ankle Society ankle-hindfoot score were significantly elevated[(84.67±9.00)vs(80.12±7.53)](all P<0.05).Conclusion:The combination of subtalar arthroereisis and surgery can more effectively rectify the deformity of the subtalar joint across multiple planes and restore the hindfoot alignment.It represents a straightforward and efficacious approach for treating flexible flatfoot in adolescents,with remarkable clinical benefits.

关 键 词：距下关节制动术 青少年 扁平足 

分 类 号：R682[医药卫生—骨科学]