| 距下关节植入物手术在平足症的争议 |
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Received:August 31, 2021
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| 期刊信息：《中国骨伤》2022年35卷，第12期，第1166-1169页 |
| DOI：10.12200/j.issn.1003-0034.2022.12.011 |
| 基金项目:国家重点研发计划（编号：2018YFC2001504） |
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| 平足可分为柔性平足和僵硬性平足。而当平足患者出现症状则称为平足症，保守治疗效果不佳则需要手术治疗。距下关节植入物手术（subtalar arthroereisis，SA）是一种微创手术，尽管应用于柔性平足症多年且取得良好疗效，但仍有诸多争议之处。争议点集中于其适应证与禁忌证、年龄、单独使用与否、可吸收材料植入物的疗效与安全性以及植入物去除。本文对其争议总结如下：SA最佳适应证是儿童及青少年柔性平足症，10~12岁是最佳治疗年龄；跗骨联合伴平足及成人平足是相对适应证。僵硬性平足、韧带过度松弛、距下关节炎是距下关节植入物手术的绝对禁忌；肥胖、神经源性柔性平足是相对禁忌证。SA的矫形能力有限，可根据实际情况联合其他手术。可吸收材料植入物的安全性和有效性已得到研究证实。没有必要常规去除植入物，去除主要原因是跗骨窦区疼痛。 |
| [关键词]:平足 柔性平足症 距下关节植入物 距下关节植入物手术 |
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| Controversy of subtalar arthroereisis in symptomatic flatfoot |
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| Abstract:Flatfoot could be divided into flexible flatfoot and rigid flatfoot. Flatfoot with symptoms is called symptomatic flatfoot, surgical treatment is required if conservative treatment is not effective. Subtalar arthroereisis is a minimally invasive procedure which has been used for many years with good results in flexible flatfoot, however, still has many controversial points. Controversial points focus on indications and contraindications, optimal age, subtalar arthroereisis alone or not, efficacy and safety of absorbable material implants, and implant removal. The paper reviewed and summarized the use and controversies of subtalar arthroereisis in symptomatic flatfoot as follows:the best indication for subtalar arthroereisis was pediatric flexible flatfoot syndrome and aged from 10 to 12 years old was optimal age for treatment;tarsal coalitions with flatfoot and adult flatfoot were relative indications. Stiff flatfoot, joint laxity, and subtalar arthritis were contraindications;obesity and neurogenic flexible flatfoot were relative contraindications. The correction ability of subtalar arthroereisis alone was limited, and it's combined with other procedures depending on patient's situation. The safety and efficacy of absorbable material implants had been reported. Routine removal of the implant was not necessary, the main reason of which was tarsal sinus pain. |
| KEYWORDS:Flatfoot Symptomatic flexible flatfoot Subtalar joint implant Subtalar arthroereisis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈城,施忠民.距下关节植入物手术在平足症的争议[J].中国骨伤,2022,35(12):1166~1169 |
| 英文格式: | CHEN Cheng,SHI Zhong-min.Controversy of subtalar arthroereisis in symptomatic flatfoot[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(12):1166~1169 |
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