【摘 要】
:
三关节融合术是治疗Ⅲ期僵硬性平足的经典术式。但Ⅲ期僵硬性平足还同时存在因胫后肌腱失功能造成的内外翻肌力不平衡的问题,在重建后足关节正确对位对线的同时,是否应考虑纠正肌力不平衡问题以消除其对融合关节施加的致畸力量,从而获得更好的长期手术疗效,这在既往的国内外文献中均未见报道。本文结合足部肌肉的生物力学特点,以及神经肌肉系统疾病造成的僵硬性足部畸形在行骨性矫形手术同时一定要处理肌力不平衡问题的经验,强
【机 构】
:
首都医科大学附属北京同仁医院足踝矫形中心,北京100730 山东兖矿集团鲍店矿医院骨科,山东邹城2
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三关节融合术是治疗Ⅲ期僵硬性平足的经典术式。但Ⅲ期僵硬性平足还同时存在因胫后肌腱失功能造成的内外翻肌力不平衡的问题,在重建后足关节正确对位对线的同时,是否应考虑纠正肌力不平衡问题以消除其对融合关节施加的致畸力量,从而获得更好的长期手术疗效,这在既往的国内外文献中均未见报道。本文结合足部肌肉的生物力学特点,以及神经肌肉系统疾病造成的僵硬性足部畸形在行骨性矫形手术同时一定要处理肌力不平衡问题的经验,强调通过三关节融合获得后足静态力线稳定的同时需要行趾长屈肌腱转位以替代胫后肌腱内翻功能,以便能维持中足与后足的动力平衡,收到更好的临床效果。
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