肌力平衡术治疗儿童先天性马蹄内翻足
古浩然;籍婧睿;周武平;易守红;
摘要(Abstract):
[目的]探讨肌力平衡术治疗儿童先天性马蹄内翻足(CCF)的临床应用及近期疗效。[方法] 2013~2018年采用肌力平衡术治疗儿童先天性马蹄内翻足33例共46足,所有患儿均采取肌力平衡术治疗,即保持踝关节背伸5°~1O°,"Z"字型延长跟腱,外移胫骨前肌腱,适当松解足后方软组织,术后长腿矫形石膏屈膝90°制动。术后6周拆石膏、拆线,不需要穿戴Dennis-Brown支具,行功能锻炼。[结果]所有患儿均顺利完成手术。术后平均随访(23.79±6.43)个月,本组33例共46足CCF均采用Pirani评分分类,矫正后接近正常39足,轻度异常7足,无中度、重度异常者。所有病例均无伤口感染、皮肤坏死和顽固性疼痛等。[结论]肌力平衡术是治疗儿童先天性马蹄内翻足的一种理想手术方式,其特点是术中充分松解,术后并发症少,畸形纠正彻底,矫形效果好。
关键词(KeyWords): 肌力平衡术;先天性马蹄内翻足;儿童
基金项目(Foundation):
作者(Author): 古浩然;籍婧睿;周武平;易守红;
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DOI:
参考文献(References):
- [1] Miedzybrodzka Z. Congenital talipes equinovarus(clubfoot):adisorder of the foot but not the hand[J]. Janat, 2003, 202(1):37-42.
- [2] Pandey S, Pandey AK. The Classification of clubfoot practical approach[J]. The Foot, 2003, 13:61-65.
- [3] Leek I, Lancashire RJ, Atlas S, et al. Birth prevalence of malformation in members of diferent ethnic groups and the offspring of matings be-tween them in Birmingham, England[J]. J Epidemiolo Commun Health, 1995, 49:171-179.
- [4] Lampasi M, Bettuzzi C, Palmonari M, et al. Transfer ofthe tendon of tibialis anterior in relapsed congenital clubfoot:long-term results in 38 feet[J]. J Bone Joint Surg, 2010, 92(2):277-28.
- [5] Farsetti O, Caterini R, Maneini F, et al. Anterior tibial tendon transfer in relapsing congenital clubfot:long-term follow--up study of two series treated with a diferent protocol[J]. J Pediatr Orthop, 2006, 26(1):83-9O.
- [6]杜士新,吉士俊,潘晓丽,等.先天性马蹄内翻足的神经电生理研究[J].中国矫形外科杂志, 2004, 12(23/24):1842-1844.
- [7] Garceau GJ, Manning KR. Transposition of anterior tibia:tendon in treatment of recurrene of congenital clubfoot[J]. J Bone Joint Surg(Am), 1949, 29:1044.
- [8]陆裕朴,王庆良,黄耀添.先天性马蹄内翻足以早期肌力平衡为主的手术治疗效果[J].中华骨科杂志, 1985, 5(2):69.
- [9] Goksan SB, Bursali A, Bilgili F, et al. Ponseti tee-hnique for the correction of idiopathic clubfeet presentingup to 1 year of age. A prehminary study in children with untreated or complex deformities[J]. Arch Orthop Trauma Surg, 2006, 126(1):15-21.