Abraham E, Waxman B, Shirali S, Durkin M
Department of Orthopaedics, University of Illinois at Chicago, 60612, USA.
J Pediatr Orthop. 1999 May-Jun;19(3):404-10.
A retrospective review of congenital cleft foot was done on 16 patients with 32 involved feet. The average age at the time of surgery was 4 years (range, 5 months to 13 years). The average follow-up after surgery was 7.8 years, with a range of 2-45 years. A simple classification based on severity of deficiency was developed. Twenty-three of the 24 procedures performed gave a satisfactory result. Six of the nine untreated feet were satisfactory. Based on our classification, the following treatment is recommended: type I, central partial forefoot cleft was treated by a soft-tissue syndactylism and a partial hallux valgus correction, if needed. Type II, for a complete forefoot cleft to the tarsus, soft-tissue syndactylism with first-ray osteotomy if necessary before age 5 years is recommended. First-ray amputation is advised after age 5 years. Type III: Complete absence of first through fourth ray did not need forefoot surgery.
对16例患者的32只患足进行了先天性裂足的回顾性研究。手术时的平均年龄为4岁（范围为5个月至13岁）。术后平均随访7.8年，范围为2至45年。制定了一种基于缺损严重程度的简单分类方法。所实施的24例手术中有23例效果满意。9只未治疗的足中有6只情况良好。根据我们的分类，建议采用以下治疗方法：I型，中央部分前足裂采用软组织并趾术治疗，必要时进行部分拇外翻矫正。II型，对于累及跗骨的完全性前足裂，建议在5岁前必要时行软组织并趾术并进行第一跖骨截骨术。5岁后建议行第一跖骨截肢术。III型：第一至第四跖骨完全缺如无需进行前足手术。
