Frischhut B, Stöckl B, Landauer F, Krismer M, Menardi G
Department of Orthopaedic Surgery, University of Innsbruck, Austria.
J Pediatr Orthop B. 2000 Jun;9(3):161-9. doi: 10.1097/01202412-200006000-00005.
Spina bifida is generally accompanied by a high incidence of foot deformities. The goal of management is to achieve a plantigrade foot. Deformities are related to the level of the lesion. With thoracic lesions, the most frequent deformity is an equinus lesion (55%), a club foot with mid-lumbar lesion (87%) and a calcaneal foot with sacral lesions (34%). No deformity was present in 56% of feet in sacral lesion children. Club foot surgery before the age of 2 years entails a high rate of recurrence (78%), necessitating redo surgery. A calcaneo-valgus deformity developed in 45% of ambulating patients with sacral lesions requiring operative stabilization of the foot. Patients with sacral lesions were almost the only ones who remained ambulators. Ambulation was not seen to be related to foot deformities in adolescents and young adults.
脊柱裂通常伴有较高的足部畸形发生率。治疗的目标是实现足底着地的足部形态。畸形与病变水平相关。对于胸段病变,最常见的畸形是马蹄足畸形(55%),中腰段病变时为畸形足(87%),骶段病变时为仰趾足(34%)。骶段病变患儿中56%的足部无畸形。2岁前进行畸形足手术会有较高的复发率(78%),需要再次手术。45%需要对足部进行手术稳定的骶段病变行走患者出现了跟骨外翻畸形。骶段病变患者几乎是仅有的仍能行走的患者。在青少年和青年成人中,行走能力与足部畸形未见关联。