Karlström G, Lönnerholm T, Olerud S
J Bone Joint Surg Am. 1975 Oct;57(7):893-900.
Twenty-three cases of claw foot with limited talocrural and subtalar mobility were the result of muscle contracture of the leg after tibial-shaft fracture. A roentgenographic study including arteriography was performed. It was concluded that the typical short cavus foot is due to fibrous contracture of the muscles in the deep posterior compartment caused by vascular damage, swelling in the deep posterior compartment, or severe muscle laceration. On physical examination the distance between the lateral malleolus and the Achilles tendon was shortened in comparison with the sound side in all cases. This was found to be caused by dorsiflexion in the talocrural joint coincident with adduction in the mid-tarsal joint. The angulation of the foot forced the patients to rotate the leg outward in order to get the feet in parallel position for walking. This deformity could be misinterpreted as an inward malrotation of the tibial fracture. In severe cases a derotating three-dimensional wedge osteotomy of the distal part of the tibia was performed with promising results.
23例踝关节和距下关节活动受限的爪形足是胫骨干骨折后腿部肌肉挛缩所致。进行了包括动脉造影在内的X线研究。得出的结论是，典型的短弓形足是由于血管损伤、后深间隙肿胀或严重肌肉撕裂导致后深间隙肌肉纤维挛缩所致。体格检查发现，所有病例中外踝与跟腱之间的距离较健侧缩短。发现这是由于踝关节背屈与中跗关节内收同时发生所致。足部的成角迫使患者向外旋转腿部，以便使双脚在行走时处于平行位置。这种畸形可能被误解为胫骨骨折向内旋转畸形。在严重病例中，对胫骨远端进行了三维楔形旋转截骨术，效果良好。
