摘要
[目的]探讨Ilizarov技术联合跟腱经皮多点松解术治疗僵硬型马蹄足畸形的临床疗效。[方法]回顾性分析2007年1月~2012年6月,应用Ilizarv牵伸术治疗僵硬型马蹄足畸形患者32例,根据对跟腱的处理方式分为跟腱非处理组(A)和跟腱经皮多点松解组(B)。术前拍负重位足踝正侧位X线片,测量并记录反应马蹄程度的胫跟角、胫距角。应用Ilizarov外固定架牵伸矫形,术后3~5 d开始调节外架,记录外架矫形时间,拍X线片测量胫跟角、胫距角,应用Laaveg-Ponseti法进行疗效评价。[结果]A组与B组患者均完成马蹄足畸形的矫正,畸形矫正满意,术后应用Laaveg-Ponseti法进行疗效评价,A组与B组比较,P>0.05,差异无统计学意义;而A组与B组马蹄足畸形矫正所需时间的比较,P<0.05,差异有统计学意义,B组所需矫形时间短于A组。所有患者均未出现皮肤坏死、血管神经损伤等并发症。[结论]应用Ilizarov技术联合跟腱经皮多点松解术治疗僵硬型马蹄足是一种安全可靠、疗效确切的微创方法,并能有效缩短矫形周期,大大减少佩戴外固定架时间。
[Objective] To explore the clinical effectiveness of Ilizarov technique combined with percutaneous multi- point achilles tendon release for the treatment of stiff equinus deformity.[Methods] There were 32 stiff equines cases treated with Ilizarov technique from January 2007 to June 2012 in our hospital.The group A was non- treated group without the achilles tendon,and the group B was with percutaneous achilles tendon multi- point release lengthening.We measured two angles,tibial-calcaneal angle and tibiotalar angle,and took the weight- bearing ankle radiograph.Ilizarov external fixator was used for drafting and adjusting equinus deformity.3~5 days postoperative,we began to adjust the external fixator,corrected clubfoot malformation to a predetermined angle.The external fixator orthopaedic time was recorded,tibial calcaneal angle and tibiotalar angle were filmed and measured.Laaveg- Ponseti method was used to evaluate the clinical effectiveness.[Results] Patients in group A and group B all completed orthopedic angle and were satisfacted to the effects.Laaveg- Ponseti method was no difference between group A and group B,but the orthopaedic time had a significant difference(P<0.05).Group B needed shorter time than group A.All patients did not appear the skin necrosis,blood vessels and nerve damage,and other complications.[Conclusion] Ilizarov technology with percutaneous multi- point achilles tendon release are safe and effective to treat stiff equinus,and can effectively shorten the orthopedic cycle and greatly reduce wearing external fixator time.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第23期2356-2361,共6页
Orthopedic Journal of China
