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程度的手抄本研究

联合行动用到跟颅內移截颅、侧廊柱更长的切除技术是疗法 IIB 期平躯病患者的常见步骤。如何避免前躯外展斜视以致于整形，最终实现空无疗法和改进治果。本文就此弊端展开学术研究，供大家参看！

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，有译者提出联合行动用到跟颅內移截颅、侧廊柱更长以及骨骼切除技术疗法 IIB 期平躯病患者。近几年来，越来越多的史籍提出了有效整形某种特定斜视所需要的药剂学标准。

•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.

本文中所，译者参考了其疗法 IIB 期平躯的切除步骤。更不可或缺的是探讨了术前确切跟颅內移截颅的歪斜相对和侧廊柱更长中所避免前躯外展斜视以致于整形最大相对的步骤，最终实现空无疗法和改进治果。

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.

同时译者也探讨了疗法 IIB 期平躯中所短期和曾一度的并发病患者情况

Background introduction

•The definition of Stage IIB Flatfoot

talar head uncoverage> 30%

•MCO 跟颅內移截颅

Koutsgiann, medial displacement 1/3-1/2

•LCL 侧廊柱更长

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)

跟颅內移截颅可以降低内侧纵弓的应力，內移跟腱止点，但理想的內移相对尚无确切。极少的尸体生物力学实验建议內移 10 mm.

•LCL

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

侧廊柱更长切除可以整形前躯的外展斜视，同时可以整形约 60% 的后躯屈曲斜视

参看史籍 ：

•LCL overcorrection will lead to

lateral column rigidity stress fracture of 5th metatarsal

但侧廊柱更长以致于似乎致使躯侧纵弓的僵硬，第 5 跖颅应力以致于集中所后的病理性颅折。

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

如何通过恰当的斜视整形来前提恼火的治果呢？