摘要
[目的]探讨采用Ponseti法矫正不同月龄先天性马蹄内翻足的疗效。[方法]将2010年1月~2015年1月于本院采用Ponseti法矫正先天性马蹄内翻足的患儿共528例704足纳入本研究。根据年龄不同分为三组:新生儿期95例148足,小婴儿期262例342足,婴儿期169例214足。采用Ponseti法进行治疗,主要包括手法矫正、石膏固定、经皮跟腱切断和足外展支具固定。术后随访,治疗前后采用Dmieglio评分系统进行评分及分型。[结果]各月龄组均随Dmieglio分型等级增加,石膏固定次数显著增多,差异有统计学意义(P<0.05)。但各Dmieglio分型等级,不同月龄组患儿的患足石膏固定次数差异无统计学意义(P>0.05)。各月龄分组患儿治疗前Dmieglio评分随分型等级增加而增加,组间比较差异均有统计学意义(P<0.05);各月龄分组患儿末次随访时Dmieglio评分随分型等级增加而增加,组间比较差异均有统计学意义(P<0.05);各月龄分组中,与治疗前相比,各Dmieglio分型患儿末次随访时Dmieglio评分均有所降低,差异均有统计学意义(P<0.05)。相同时间点,各Dmieglio分型患儿在不同月龄分组间差异均无统计学意义(P>0.05)。528例704足中,507例673足疗效满意,其中新生儿期组优良率为96.08%、小婴儿期组为95.45%、婴儿期组为95.57%,三组间临床结果优良率的差异无统计学意义(P>0.05)。[结论]对于1岁以内的先天性马蹄内翻足幼儿,Ponseti法保守治疗的矫形效果确切,疗效与Dmieglio分型相关。
[Objective] To explore the effect of Ponseti method in correction of congenital clubfoot in different ages.[Methods] From January 2010 to January 2015, 528 infants(704 feet) with congenital talipes equinovarus were treated by Ponseti method. They were divided into three groups according to the month age beginning the treatment, including 95 cases(148 feet)in the neonatal period, 262 cases(342 feet) in the early infantile period and 169 cases(214 feet) in the infantile period. Ponseti method was used for treatment, including manipulative correction, plaster cast fixation, percutaneous Achilles tenotomy and foot abduction brace. The Dmieglio score system was used for scoring and typing before and after treatment.[Results] With the increase of Dmieglio classification, the number of gypsum fixation increased significantly in each month group(P<0.05). However, there was no significant difference in Dmieglio classification and the number of foot plaster fixation in different age groups(P>0.05). The Dmieglio score of each month group increased with the increase of classification grade before treatment, and there were significant differences between groups(P<0.05). The Dmieglio score of each month group increased with the increase of classification grade at the last follow-up, and there were significant differences between groups(P<0.05). In each month group,compared with before treatment, the Dmieglio scores were decreased, and the difference was statistically significant(P<0.05).At the same time point, there was no significant difference in Dmieglio classification among different age groups(P>0.05). Of them, 507 infants(673 feet) achieved excellent and good results, associated with the excellent and good rate of 96.08% in the neonatal group, 95.45% in the early infantile group and 95.57% in the infantile group, which proved no statistically significant(P>0.05).[Conclusion] Ponseti’s conservative treatment is effective for congenital talipes equinovarus in children under 1 year old. The effect is related to Dmieglio classification.
作者
谭晓谦
梅海波
赫荣国
唐进
伍江雁
朱光辉
叶卫华
TAN Xiao-qian;MEI Hai-bo;HE Rong-guo;TANG jin;WU Jiang-yan;ZHU Guang-hui;YE Wei-hua(Hunan Children's Hospital,Changsha 410007,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第11期996-1000,共5页
Orthopedic Journal of China
基金
湖南省科学技术厅科技计划项目(编号:2013SK3220)
