ZANG Jiancheng 1,2 , PAN Xuyue 1,2 , CUI Yidong 3 , XIAO Li 4 , WEI Fangyuan 1,2 , CHEN Zhaojun 1,2 , WANG Zhengyi 1,2
  • 1. Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, P. R. China;
  • 2. “Traditional Chinese Orthopedics and Sports Rehabilitation Intelligentization” Engineering Research Center of Ministry of Education, Beijing, 100029, P. R. China;
  • 3. Department of Orthopedics, the First Affiliated Hospital Of Shandong First Medical University, Jinan, 250013, P. R. China;
  • 4. School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, 100876, P. R. China;
WEI Fangyuan, Email: footwfy@126.com
Knee joint deformity; lower leg deformity; foot and ankle deformities; hybrid surgical method
10.7507/1002-1892.202505056
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Objective  To summarize the clinical characteristics of foot and ankle deformities combined with knee and lower leg deformities and evaluate the advantages, clinical outcomes, and considerations of Qin Sihe hybrid surgical method for treating such complex deformities. Methods  Between January 2022 and December 2024, 32 patients with foot and ankle deformities combined with knee and lower leg deformities were enrolled. The cohort included 23 males and 9 females, aged 10-67 years (mean, 41.0 years). The main etiologies included post-polio sequelae (20 cases) and congenital limb deformities (3 cases). Deformities were categorized as follows: equinovarus foot (12 cases), equinus foot (2 cases), equinovalgus foot (3 cases), equinus foot with swan-neck deformity (2 cases), calcaneus foot (5 cases), foot valgus (2 cases), knee flexion deformity (13 cases), genu recurvatum (4 cases), genu varum (3 cases), genu valgum (3 cases), lower limb shortening (3 cases), and lower limb external rotation (6 cases). Qin Sihe hybrid surgical interventions included osteotomies, tendon releases, and tendon transfers for deformity correction, followed by external fixation for residual deformity adjustment and stabilization. Outcomes were assessed using Qin Sihe's Postoperative Evaluation Criteria for Lower Limb (Foot and Ankle) Deformity Correction and Functional Reconstruction. Results  All patients were followed up 6-32 months (mean, 16.5 months). Complications included pin tract infection (1 case, 1 site), ankle pain (2 cases), delayed healing at the proximal tibial osteotomy site (1 case), and anterior talar dislocation (1 case). At last follow-up, insufficient correction of foot deformity was observed in 1 case; both knee and lower leg deformities were corrected, with only mild recurrence of knee flexion deformity in 1 case. The foot/ankle and knee joint function improved. Based on Qin Sihe's Postoperative Evaluation Criteria for Lower Limb (Foot and Ankle) Deformity Correction and Functional Reconstruction, outcomes were rated as excellent in 30 cases and good in 2 cases, with an excellent-good rate of 100%. Conclusion  Foot and ankle deformities combined with knee and lower leg deformities are complex, Qin Sihe hybrid surgical method achieves satisfactory clinical outcomes for simultaneous correction.

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