目的  通过影像学及临床结果评价成人高弓内翻足畸形的手术疗效。 方法  对13例（19足，男7例，年龄16～48岁，平均31.4岁）高弓内翻足手术矫形患者的临床及影像学结果进行分析，临床评估包括疼痛缓解程度、足部力线及整体功能，使用AOFAS足踝部功能评分，通过足前后位及负重侧位X线片评估手术前后Meary’s角、Hibb’s角、跟骨倾斜角及距跟角的变化，评价不同类型患者的手术适应症及疗效。  结果  本组平均随访4.5年（2～11年），平均AOFAS得分为76.7/100；68.5％疼痛显著缓解；Meary’s角平均减少15.4；Hibb’s角平均减少23.3；跟骨倾斜角平均减少8.6；距跟角平均增加2.4；整体优良率为68.4％。 结论 手术矫正高弓内翻足畸形的整体功能恢复较好，但疼痛缓解程度并不令人满意。高弓内翻足为复合畸形，任何单一的手术都不能很好的改善所有症状。三关节融合虽然为挽救性手术，但融合率高，且术后疼痛及功能恢复均较好，对于合适的患者可以作为首选术式。但对于截骨矫形可以纠正的畸形，尽量避免过早和过度关节融合术。

 

Objective Evaluate the surgical outcomes of adult cavovarus foot deformity of radiological and clinical results. Method The study concerned 19 cavus feet in 13 patients (7 males; ages from 16～48 years, mean 31.4). Clinical outcome was assessed in terms of pain, alignment of foot, and function using the AOFAS scores. Radiological assessment (anteroposterior and lateral stress X-ray) measured the Meary’s angle, Hibb’s angle, calcaneal inclination angle, and talocalcaneal angle. Result Mean follow-up was 4.5 years (range, 2～11). Mean AOFAS score at follow-up was 76.7/100 points (range, 57～100). Pain decreased considerably in 68.5% of cases; Mean Meary’s angle show 15.4 decrease, Hibb’s angle decrease 23.3, calcaneal pitch angle decrease 8.6, and talocalcaneal angle increase 2.4; Objective outcome was excellent or good in 68.4% of feet. Conclusion Outcome in terms of function and motion was good, although pain relief results were not satisfy. Pes cavus deformity is complex, any procedure can not correct all the deformities. Triple arthrodesis although is a salvage procedure, but the fusion rate was high and after this procedure patients suffer less pain and have better function, thus can be the prior choice for the appropriate patients. But if the osteotomies can correct the deformities satisfy, triple arthrodesis should be reserved.

Kyewords:高弓内翻足； 高弓足； 手术； 关节融合； 影像