Osteotomy combined with soft tissue balancing for flexible cavovarus foot deformity secondary to Charcot-Marie-Tooth disease
Objective:To evaluate the clinical and radiographic outcomes following osteotomy combined with soft tissue balancing for flexible cavovarus foot deformity secondary to Charcot-Marie-Tooth disease (CMT). Methods:A retrospective analysis was conducted on the clinical data of 25 patients (30 feet) with CMT-induced flexible cavovarus foot deformity who underwent osteotomy and soft tissue balancing at the Department of Foot and Ankle Surgery,Honghui Hospital Affiliated to Xi'an Jiaotong University from August 2018 to August 2021. The cohort included 18 males and 7 females,with a mean age of 33.1±8.3 (ranging 16-42) years. The clinical outcomes[including the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale,Maryland Foot Score,and range of motion (ROM) of ankle dorsiflexion and plantarflexion]and radiological parameters (including the talus-first metatarsal angle measured from weight-bearing anteroposterior X-rays;the Meary angle,calcaneal inclination angle,and Hibbs angle measured from weight-bearing lateral X-rays;and the hindfoot alignment angle measured from posterior foot Saltzman lateral X-rays) were compared preoperatively and at the 1-year follow-up. Results:All patients were followed for 12 to 30 months,with a mean of (18.3±7.5) months. At the 1-year follow-up,significant improvements were observed in the AOFAS Ankle-Hindfoot Scale,the Maryland foot score and the ROM of ankle dorsiflexion compared to preoperative values (all P<0.05). However,there was no statistically significant difference in the ankle plantar flexion ROM (P>0.05). Radiographic analysis at the 1-year follow-up revealed significant reductions in the talus-first metatarsal angle,Meary angle,calcaneal inclination angle,and hindfoot alignment angle,while a significant increase the Hibbs angle compared to preoperative measurements (all P<0.05). No patient experienced surgery-related complications such as local numbness,delayed bone healing,nonunion,malunion,internal fixation breakage,or deep vein thrombosis of the lower limbs. Conclusions:Osteotomy combined with soft tissue balancing for CMT-induced cavovarus foot deformity can improve patient function,increase the AOFAS Ankle-Hindfoot Scale and Maryland Foot Score,increase ankle dorsiflexion ROM,effectively correct the alignment of the ankle and foot,and achieve significant clinical outcomes with high patient satisfaction.
万方数据
维普
