Cottalorda J, Gautheron V, Metton G, Charmet E, Chavrier Y
Orthopaedic Paediatric Surgery Department, University of Medicine, Saint-Etienne, France.
J Bone Joint Surg Br. 2000 May;82(4):541-4. doi: 10.1302/0301-620x.82b4.10188.
Our aim in this retrospective study was to analyse the value of serial corrective casts in the management of toe-walking in children aged less than six years with cerebral palsy. A total of 20 children (10 hemiplegic and 10 diplegic) had elongation of the triceps surae by serial casting at a mean age of four years and one month. The mean passive dorsiflexion of the foot with the knee in extension was 3 degrees (-10 to +5) and 12 degrees (0 to +15) with the knee in flexion. After removal of the cast passive dorsiflexion was 20 degrees (+10 to +30) with the knee in extension, and 28 (+10 to +35) with the knee in flexion. At a mean follow-up of 3.08 years (2.08 to 4.92), passive dorsiflexion was 9 degrees (-10 to +20) with the knee in extension and 18 degrees (0 to +30) with the knee in flexion. Serial corrective casts are useful for the treatment of equinus in young children as the procedure is simple and the results are at least equal to those of other non-operative techniques. It is a safe alternative to surgical procedures especially in young children. If the equinus recurs operation can be undertaken on a tendon which is not scarred.
我们这项回顾性研究的目的是分析连续矫正石膏在治疗6岁以下脑瘫患儿足尖行走方面的价值。共有20名儿童（10名单侧偏瘫和10名双侧偏瘫）接受了连续石膏固定以延长小腿三头肌，平均年龄为4岁1个月。膝关节伸直时足部的平均被动背屈角度为3度（-10至+5度），膝关节屈曲时为12度（0至+15度）。去除石膏后，膝关节伸直时被动背屈角度为20度（+10至+30度），膝关节屈曲时为28度（+10至+35度）。平均随访3.08年（2.08至4.92年）时，膝关节伸直时被动背屈角度为9度（-10至+20度），膝关节屈曲时为18度（0至+30度）。连续矫正石膏对幼儿马蹄足的治疗很有用，因为该方法简单，且效果至少与其他非手术技术相当。对于手术治疗来说，它是一种安全的替代方法，尤其适用于幼儿。如果马蹄足复发，可以对未形成瘢痕的肌腱进行手术。
