Innovative surgical treatment of tarsal coalition in flatfoot: Resection and interposition of synthetic membrane, flexible bioresorbable polymers film, as adhesion barrier and subtalar arthroeresis. Up to nine years follow-up.

IF 1.9 3区 医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2024-10-18 DOI:10.1016/j.fas.2024.10.003
L Peretto, D Priano, M Laquidara, A Memeo
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Abstract

Tarsal coalition can be a long term severely disabling condition. For symptomatic cases with flatfoot surgical resection of coalition and subtalar arthroeresis represents the most common treatment. Literature reports variable outcomes and recurrence. The aim was to achieve optimal correction with no recurrence. This retrospective study presents, reporting results, an innovative technique that provides numerous advantages and improved outcomes. Nineteen patients suffering from painful flatfoot from tarsal coalition were, consecutively, surgically treated by resection of tarsal coalition with interposition of a synthetic flexible bioresorbable polymers membrane as an adhesion barrier and by subtalar arthroeresis. AOFAS scores were used to rate the clinical severity and X-ray/ CT to evaluate the extent of tarsal coalition. Patient's age at time of surgery ranged from 12 to 21. The period examined runs from November 2010 to November 2019. Results were evaluated (up to 9 years follow-up) clinically by AFOAS scores and radiologically by X-ray/CT. AOFAS scores improved in all patients with significant (p < 0.01) pain reduction or disappearance, corrected alignment and increased function, biomechanics of the foot and mobility. X-ray showed no recurrence of coalition in all but one case. There were no complications and patients reported a significant improvement in quality of life. Our study shows that surgical resection of coalition, and correction of flatfoot by subtalar arthroeresis, with the innovative use of a flexible bioresorbable polymers membrane as an adhesion barrier, obtained excellent overall results and importantly prevented recurrence. We believe this technique represents a great option. LEVEL OF CLINICAL EVIDENCE: 4.

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扁平足跗骨联合的创新手术治疗:切除并植入合成膜(柔性生物可吸收聚合物薄膜)作为粘连屏障和跗骨关节置换术。随访长达九年。
跗关节炎是一种长期严重致残的疾病。对于有症状的扁平足病例,最常见的治疗方法是手术切除跗骨联合,并进行踝关节置换术。文献报道的治疗效果和复发率各不相同。我们的目标是达到最佳矫正效果且不复发。这项回顾性研究报告了一项创新技术的结果,该技术具有诸多优点,并能改善治疗效果。19 名因跗骨联合引起扁平足疼痛的患者连续接受了跗骨联合切除手术,同时植入合成柔性生物可吸收聚合物膜作为粘连屏障,并进行了踝关节置换术。AOFAS 评分用于评定临床严重程度,X 光/CT 用于评估跗骨联合的范围。手术时患者的年龄在 12 至 21 岁之间。研究时间为 2010 年 11 月至 2019 年 11 月。研究结果(长达9年的随访)通过AOFAS评分进行临床评估,并通过X光/CT进行放射学评估。所有患者的 AOFAS 评分均有显著改善(p
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来源期刊
Foot and Ankle Surgery
Foot and Ankle Surgery ORTHOPEDICS-
CiteScore
4.60
自引率
16.00%
发文量
202
期刊介绍: Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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