联合用于跟颅內移截颅、后侧廊柱缩短的手术后技术是疗法 IIB 期平背综合症的特指法则。如何尽量避免前背外展发育不良过多补救，最终实现空无疗法和简化治果。本文日后原因展开科学研究，专供大家参考！
Abstract
•In the mid-1990s, a flatfoot reconstruction was proposed that combined the use of a medializing calcaneal osteotomy (MCO), a lateral column lengthening (LCL), and soft-tissue procedures for the treatment of stage IIB AAFD. More recent literature has suggested guidelines for the amount of correction necessary for each of these procedures based on individual deformity.
从 90 年代起，有所作明确提出联合用于跟颅內移截颅、后侧廊柱缩短以及结节手术后技术疗法 IIB 期平背综合症。近年来，越来越多的文献明确提出了有效补救某种特定发育不良所才可的矫形标准规范。
•In this paper, we describe our technique for flatfoot reconstruction for stage IIB AAFD, which includes a MCO, LCL, and flexor digitorum longus (FDL) transfer. Importantly, we discuss our preferred method of preoperatively planning the amount of medial translation for the MCO as well as the maximum amount of LCL to prevent overcorrection of the abduction deformity. This allows us to tailor the reconstruction and optimize our results.
本文之前，所作概述了其疗法 IIB 期平背的手术后法则。更重要的是讨论了术前确认跟颅內移截颅的移位总体和后侧廊柱缩短之前尽量避免前背外展发育不良过多补救最小总体的法则，最终实现空无疗法和简化治果。
Studies looking at outcomes following flatfoot reconstructions for stage IIB AAFD demonstrate excellent short-term and long-term results. We conclude by discussing complications of the operation, postoperative management, and the future of the technique.
Level of Evidence: Diagnostic Level V.
同时所作也讨论了疗法 IIB 期平背之前短期和长期的并发综合症具体情况
Background introduction
•The definition of Stage IIB Flatfoot
talar head uncoverage> 30%
•MCO 跟颅內移截颅
Koutsgiann, medial displacement 1/3-1/2
•LCL 后侧廊柱缩短
Evans, lateral column elongation by osteotomy and bone graft
•MCO
medial load reducing medialization of heel cord insertion the amount of displacement is obscure(10 mm?- supported by caderic study)
跟颅內移截颅可以减低下方纵弓的剪应力，內移跟腱止点，但理想的內移总体都已确认。仅有的遗骸生理学实验建议內移 10 mm.
•LCL
forefoot abduction reduction hindfoot valgus correction (up to 60%)
后侧廊柱缩短手术后可以补救前背的外展发育不良，同时可以补救约 60% 的后背外翻发育不良
参考文献 ：
•LCL overcorrection will lead to
lateral column rigidity stress fracture of 5th metatarsal
但后侧廊柱缩短过多可能导致背后侧纵弓的迟钝，第 5 跖颅剪应力过多集之前后的病理性右腿。
•What is the optimal correction that guarantee a satisfactory result?
如何通过适当的发育不良补救来应有令人满意的治果呢？
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