摘要
目的应用Dimeglio足评分方法，评价肌力平衡术治疗先天性马蹄内翻足的远期效果，以指导治疗方法的改进。方法本组共42例，64足，手术时年龄4．5个月～3．5岁（平均1．1岁），均行肌力平衡Ⅰ期矫形术。〈1岁组33足，≥1岁组31足。术前按Dimeglio方法分组，中度畸形组（Ⅱ、Ⅲ型）共34足，重度畸形组（Ⅳ型）共30足。结果随访5．0～10．5年（平均8．2年），随访时评分：〈1岁组为（4．58±1．80）分，≥1岁组为（6．26±2．56）分，中度畸形组为（3．62±1．23）分，重度畸形组为（7．40±1．52）分，P〈0．01；畸形改善程度，〈1岁组为（9．61±1．41）分，≥1岁组为（9．23±1．33）分，中度畸形组为（9．15±1．31）分，重度畸形组为（9．73±1．41）分，P〉0．05。随访时按Dimeglio分型，Ⅰ型34足，Ⅱ型30足，无Ⅲ、Ⅳ型足。结论对于DimeglioⅢ型以下的马蹄内翻足，Ⅰ期行肌力平衡术可取得良好的效果，提倡同时切除外展躅肌；而对于Ⅳ型足则应采用广泛的软组织松解术。
Objective To evaluate the long-term results of muscle-strength balancing procedure in the treatment of congenital clubfoot. Methods Forty-two children with 64 clubfeet were treated by muscle-strength balancing procedure. The average age at the time of surgery was 1.1 years （range： 4. 5 months to 3. 5 years）. The anterior tibial tendon was transplanted to middle or lateral cuneiform and the Achilles tendon was lengthened. The clinical outcomes were evaluated according to the Dimeglio classification. Pre-operatively, the patients were divided into two groups;Group A consisted of 34 feet with grade Ⅱ or Ⅲ deformity. Group B consisted of 30 feet with grade Ⅳ deformity. Results All patients were followed up for an average 8. 2 years （range： 5.0 to 10. 5 years）. Comparison of the pre-operative and the follow-up scores revealed significant improvement in all 64 feet. For the two groups of children under and above the age of 1 year, the scores improved by 9. 61 ± 1.41 and 9. 23 ± 1.33 respectively. For children with moderate and severe deformities, the scores improved by 9. 15 ± 1.31 and 9. 73 ± 1.41 respectively. Conclusions For the clubfeet of grade Ⅱ or Ⅲ excellent results can been expected from one-stage muscle-strength balancing procedure. As for those with grade Ⅳ clubfeet, complete soft tissue release procedure should been performed. Abductor hallucis excision is recommended in all procedures.
出处
《中华小儿外科杂志》
CSCD
北大核心
2008年第2期101-103,共3页
Chinese Journal of Pediatric Surgery
关键词
畸形足
先天性
肌力平衡术
预后
Clubfoot, congenital
Muscle-strength balancing procedure
Prognosis
