摘要
背景:成人僵硬性马蹄内翻足畸形复杂,临床中常见的二维检查很难准确地显示其畸形的特点。目的:探讨数字化三维重建技术在成人僵硬性马蹄内翻足手术中的应用价值。方法:回顾性分析2015年12月至2019年12月收治的成人僵硬性马蹄内翻足患者10例,共15足。所有患者术前行负重位足及踝关节的正侧位X线检查,采集全足至踝关节上方10 cm的CT断层扫描数据,输入数字化三维重建软件Mimics 21.0重建三维模型,在3-matic软件中计算距跟角、Saltzman位胫跟角及正位距骨第1跖骨角,根据Saltzman位胫跟角的正常值模拟截骨,并打印截骨导板。术中使用截骨导板行截骨融合对马蹄内翻足进行矫形。随访记录美国矫形外科足踝协会踝-后足评分(AOFAS)、SF-36评分及国际马蹄足畸形研究学组(ICFSG)评分,同时行足部及踝关节X线检查,末次随访时行CT检查,测量距跟角、Saltzman位胫跟角及正位距骨第1跖骨角。结果:10例患者均获得随访,随访时间7~24个月,平均随访(13.0±2.6)个月。末次随访时10例患者AOFAS评分、SF-36评分、ICFSG评分、距跟角、Saltzman位胫跟角均较术前改善,且差异均有统计学意义(P均<0.05)。结论:应用数字化三维重建技术对成人僵硬性马蹄内翻足进行矫正功能重建,获得了满意的临床疗效,是一种能精确评价马蹄足畸形特点及准确截骨融合的有效方法。
Background:The deformity is complex in adult rigid varus foot,and it is difficult to accurately display the characteristics of the deformity by common clinical two-dimensional examination.Objective:To investigate the application value of digital 3D reconstruction in the surgical treatment of stiff varus foot in adults.Methods:A retrospective analysis was performed in 10 adult patients(15 feet)with stiff varus foot treated between December 2015 and December 2019.All patients received weight-bearing anteroposterior-lateral X-ray examination of the foot and ankle preoperatively.CT data from the whole foot to 10 cm above the ankle joint were collected.Digital 3D reconstruction software Mimics 21.0 was input to reconstruct the 3D model.The talocalcaneal angle,Saltzman tibiocalcaneal angle and anteroposterior talar first metatarsal angle were calculated in 3-matic software.Osteotomy was simulated according to the normal value of the Saltzman tibiocalcaneal angle,and the guide plate was printed.During the operation,the plate was used to perform osteotomy and fusion to correct varus foot.The American Society of Orthopaedic Foot and Ankle Scale(AOFAS),SF-36score and International Horseshoe Foot Deformity Research Group(ICFSG)score were recorded.Foot and ankle X-ray examinations were performed at the same time.CT examination was performed at the last follow-up,the talocalcaneal angle,Saltzman tibiocalcaneal angle and anteroposterior talar first metatarsal angle were measured.Results:All the 10patients were followed up for(13.0±2.6)months on average(range,7-24 months).At the last follow-up,AOFAS score,SF-36 score,ICFSG score,talocalcaneal angle,and Saltzman tibiocalcaneal angle of 10 patients were all improved significantly(all P<0.05).Conclusions:The digital three-dimensional technology in the functional reconstruction of adult stiff equinovarus foot can achieve satisfactory clinical effect,and is an effective method to accurately evaluate the characteristics of equinovarus deformity and accurate osteotomy and fusion.
作者
李飞
李璐兵
郑辉
王雪
曹明宇
王成伟
LI Fei;LI Lubing;ZHENG Hui;WANG Xue;CAO Mingyu;WANG Chengwei(Department of Orthopaedic Surgery,The Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002;Department of Orthopaedics,The Third Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处
《中华骨与关节外科杂志》
2021年第7期611-615,631,共6页
Chinese Journal of Bone and Joint Surgery
基金
国家自然科学基金(8186030127)
