요내반족 변형에 대한 재건수술의 임상적 및 방사선학적 결과 분석 (Analysis of Clinical and Radiographic Outcome of the Reconstructive Surgery for the Cavovarus Foot Deformity)

서지정보

· 발행기관 : 대한족부족관절학회
· 수록지 정보 : 대한족부족관절학회지 / 18권 / 2호 / 62 ~ 67페이지
· 저자명 : 정홍근, 엄준상, 박재용, 이동오, 정승희

초록

Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis,soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory forachievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographicoutcome of reconstruction for cavovarus foot deformities.
Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructivesurgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores,and patient satisfaction and measured the radiographic parameters.
Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of23.9 months (range, 12∼49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet,Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each.
Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia releasein 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale painscore showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot scoreshowed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from27.5o to 46.7o. In radiographic measurements, calcaneal pitch angle improved from 19.1o to 15.8o, Meary angle from 13.0o to 9.3o, Hibb’sangle from 44.3o to 37.0o, and tibio-calcaneal axis angle from varus 17.5o to varus 1.5o.
Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructiveprocedures with improved functional, radiographic measures and high patient satisfaction.

영어초록

Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis,soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory forachievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographicoutcome of reconstruction for cavovarus foot deformities.
Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructivesurgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores,and patient satisfaction and measured the radiographic parameters.
Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of23.9 months (range, 12∼49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet,Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each.
Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia releasein 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale painscore showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot scoreshowed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from27.5o to 46.7o. In radiographic measurements, calcaneal pitch angle improved from 19.1o to 15.8o, Meary angle from 13.0o to 9.3o, Hibb’sangle from 44.3o to 37.0o, and tibio-calcaneal axis angle from varus 17.5o to varus 1.5o.
Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructiveprocedures with improved functional, radiographic measures and high patient satisfaction.

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