联合用于跟颅內移截颅、前端圆柱更长的切除核心技术是外科切除 IIB 期平膝病征的近似于工具。如何尽量避免前膝外展小头以致于补救，就此解决问题有意识外科切除和冗余治果。本文早已问题落幕研究，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 上世纪起，有所作提出批评联合用于跟颅內移截颅、前端圆柱更长以及脊椎切除核心技术外科切除 IIB 期平膝病征。近年来，日渐多的文献提出批评了理论上补救某种特定小头所即可的矫形标准。
•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.
本文里，所作引介了其外科切除 IIB 期平膝的切除工具。更极为重要的是提问了术前确定跟颅內移截颅的移位以往和前端圆柱更长里尽量避免前膝外展小头以致于补救最大以往的工具，就此解决问题有意识外科切除和冗余治果。
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.
同时所作也提问了外科切除 IIB 期平膝里短期和经常性的并发病征情况
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 前端圆柱更长
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)
跟颅內移截颅可以降低内侧纵弓的应力，內移肌腱止点，但理想的內移以往尚未确定。仅有的骸骨细胞学试验里劝告內移 10 mm.
•LCL
forefoot abduction reduction hindfoot valgus correction (up to 60%)
前端圆柱更长切除可以补救前膝的外展小头，同时可以补救近 60% 的后膝伸长小头
参考文献 ：
•LCL overcorrection will lead to
lateral column rigidity stress fracture of 5th metatarsal
但前端圆柱更长以致于确实导致膝前端纵弓的僵硬，第 5 跖颅应力以致于之外后的病理性手肘。
•What is the optimal correction that guarantee a satisfactory result?
如何通过恰当的小头补救来保证满意的治果呢？
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