Zorer Gazi, Bagatur A Erdem, Dogan Ahmet
Department of Orthopaedic Surgery and Traumatology, SSK Istanbul Training Hospital, Turkey.
J Pediatr Orthop B. 2002 Jan;11(1):60-7. doi: 10.1097/00009957-200201000-00010.
Seventeen feet of 12 patients with congenital vertical talus, which were treated with a single-stage surgical correction of complete subtalar release and peritalar reduction by using the Cincinnati incision, were reviewed. Five of the feet were associated with neuromuscular disorders, four with neural tube defects, and eight were idiopathic. All patients were operated on by the same surgeon and all were available for clinical and radiographic follow-up averaging 42.9 months (range 19-81) from the time of surgery. There were no wound complications or avascular necrosis of the talus. None required subsequent reoperation. At final follow-up, results were based on clinical and radiographic outcomes and included five excellent, eight good, two fair, and two poor. All families were satisfied with the results and appearance of the feet. Radiographically, there was a significant improvement in the anteroposterior and lateral talocalcaneal and talo-first metatarsal angles, and at follow-up, the group averages for each of these angles were within the normal ranges. In the treatment of congenital vertical talus, good clinical and radiographic outcomes can be obtained, with a low incidence of complications, using this single-stage surgical correction procedure.
回顾了12例先天性垂直距骨患者的17只足,这些足采用单一阶段手术矫正,通过辛辛那提切口进行全距下关节松解和距周复位治疗。其中5只足合并神经肌肉疾病,4只足合并神经管缺陷,8只为特发性。所有患者均由同一位外科医生进行手术,并且均能接受术后平均42.9个月(范围19 - 81个月)的临床和影像学随访。未出现伤口并发症或距骨缺血性坏死。无一例需要再次手术。末次随访时,结果基于临床和影像学表现,包括5例优、8例良、2例可、2例差。所有家庭对足部的结果和外观均满意。影像学检查显示,距骨-跟骨前后位及侧位角度以及距骨-第一跖骨角度有显著改善,随访时这些角度的组平均数值均在正常范围内。在先天性垂直距骨的治疗中,采用这种单一阶段手术矫正方法可获得良好的临床和影像学结果,且并发症发生率低。