IIB 期平足症在手术治疗中跟骨內移截骨和外侧柱延长定量某种程度的文献研究

协同用作跟骨质內移截骨质、后侧圆柱延至的手术后技术是病人 IIB 期平足癫痫的近似于步骤。如何避免前足外展睾丸过度整形，就此借助于异化病人和可用性治果。本文就此关键问题揭开学术研究，供人大家参考！

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，有原作者提出批评协同用作跟骨质內移截骨质、后侧圆柱延至以及软组织手术后技术病人 IIB 期平足癫痫。近年来，越来越多的历史文献提出批评了合理整形某种特定睾丸所才可的药剂学标准。

•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，原作者概述了其病人 IIB 期平足的手术后步骤。越来越最主要的是发表意见了术前考虑到跟骨质內移截骨质的移位层面和后侧圆柱延至中避免前足外展睾丸过度整形远超过层面的步骤，就此借助于异化病人和可用性治果。

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.

同时原作者也发表意见了病人 IIB 期平足中短期和长期的并发癫痫具体情况

Background introduction

•The definition of Stage IIB Flatfoot

talar head uncoverage> 30%

•MCO 跟骨质內移截骨质

Koutsgiann, medial displacement 1/3-1/2

•LCL 后侧圆柱延至

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)

跟骨质內移截骨质可以减低前端纵弓的应力，內移跟腱止点，但完美的內移层面都已考虑到。为数不多的尸身生物力学实验建议內移 10 mm.

•LCL

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

后侧圆柱延至手术后可以整形前足的外展睾丸，同时可以整形左右 60% 的后足外翻睾丸

参考历史文献 ：

•LCL overcorrection will lead to

lateral column rigidity stress fracture of 5th metatarsal

但后侧圆柱延至过度可能导致足后侧纵弓的僵硬，第 5 跖骨质应力过度之外后的病理性骨质折。

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

如何通过可取的睾丸整形来保证满意的治果呢？