距下关节制动术治疗儿童及青少年柔韧性平足症的临床进展

Clinical Advances in Subtalar Arthroereisis for the Treatment of Flexible Flatfoot in Children and Adolescents

摘要: 近年来，平足在儿童及青少年中的发病率呈现逐年上升的趋势，尤其是在超重及肥胖人群中，这一现象尤为显著。研究表明，超重不仅增加了足部结构的负荷，还可能导致足弓发育异常，从而加剧扁平足的发生。目前，国内外对于平足治疗的时机及方式仍存在一定争议。传统治疗方法包括足部矫形器、物理治疗以及针对性的功能锻炼，但这些方法在改善足弓结构和功能方面的效果有限，尤其是对于中重度平足患者。近年来，距下关节制动术因其操作简单、安全、微创的特点，逐渐成为治疗儿童及青少年柔韧性平足症的重要选择。该手术通过在距下关节植入制动器，限制足部过度外翻，从而恢复足弓的正常形态和功能。此外，距下关节制动术既可以作为独立手术使用，也可以与其他软组织手术联合应用，以进一步提高治疗效果。本文旨在综述距下关节制动术在儿童及青少年柔韧性平足治疗中的研究进展，为临床实践提供参考依据。

Abstract: In recent years, the incidence of flatfoot among children and adolescents has shown an increasing trend year by year, particularly in overweight and obese populations, where this phenomenon is particularly pronounced. Research indicates that overweight not only increases the load on the foot structure but may also lead to abnormal development of the arch, thereby exacerbating the occurrence of flatfoot. Currently, there is still some controversy both domestically and internationally regarding the timing and methods of flatfoot treatment. Traditional treatment methods include foot orthoses, physical therapy, and targeted functional exercises, but these methods have limited effectiveness in improving arch structure and function, especially for patients with moderate to severe flatfoot. In recent years, subtalar arthroereisis has gradually become an important option for treating flexible flatfoot in children and adolescents due to its simplicity, safety, and minimally invasive nature. This surgery involves implanting an arthroereisis device in the subtalar joint to restrict excessive foot eversion, thereby restoring the normal morphology and function of the arch. Additionally, subtalar arthroereisis can be used as a standalone procedure or in combination with other soft tissue surgeries to further enhance treatment outcomes. This article aims to review the research progress of subtalar arthroereisis in the treatment of flexible flatfoot in children and adolescents, providing a reference for clinical practice.