유연성 편평족에 대한 내측 전위 종골 절골술의 단기 추시 결과

Purpose: To evaluate the short-term results of medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot deformity. Materials and Methods: Twenty four patients (25 feet) who had undergone medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot between July 2004 and May 2007 were included. The mean age was 43.6 years (16~78 years). The mean follow-up was 26 months (14~50 months). Clinical outcomes were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Six radiographic parameters were measured from weightbearing radiographs to assess the difference between preoperative and postoperative radiographs. Results: The mean AOFAS score improved from 57.9 points preoperatively to 89.2 points at latest follow-up (p=0.000). The mean VAS improved from 62 points preoperatively to 23 points at latest follow-up (p=0.000). The mean talonavicular coverage angle on anteroposterior (AP) view changed from 20.2 degrees to 16.0 degrees (p=0.002). The mean calcaneal pitch angle on lateral view changed from 12.6 degrees preoperatively to 14.5 degrees at latest follow-up (p=0.001). Regarding these radiographic parameters, the difference between interobserver measurements was larger than that between pre- and post-operative measurements. The calcaneus was transferred medially by average 11.8 mm (p=0.003), which was 27.9% of the width of calcaneal tuberosity (p=0.000). The mean talo-first metatarsal angle on AP and lateral views, and navicular height on lateral view were not significantly changed. Conclusion: Medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot could lead to improve the clinical outcomes, although the restoration of medial longitudinal arch was not clinically significant.