Luor S I, Huang S C, Cheng P Y, Liu T K
Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1992 Mar;91(3):304-8.
In the management of congenital clubfoot, recent attention has been given to the deformity of the calcaneocuboid joint in addition to the changes in the talonavicular, talocalcaneal and ankle joints. Fifty-five patients with 86 clubfeet operated on in the past six years were retrospectively studied. Radiographically, the calcaneocuboid subluxations were graded from I to IV by the Thoemtz classification. The grading has some correlation with the gross deformity, although there is no statistical data to confirm it. Postoperatively, those with grade I feet seemed to have satisfactory results with a posterior release only or with a posteromedial release. Grade II-III feet generally required extensive posteromedial and lateral release. Those who had a calcaneocuboid release and reduction obtained better correction than those who did not. We conclude that calcaneocuboid subluxation should be appraised preoperatively and reduced during surgery in order to achieve good results.
在先天性马蹄内翻足的治疗中，除距舟、距跟和踝关节的变化外，跟骰关节的畸形近来也受到关注。对过去六年中接受手术的55例患者的86只马蹄内翻足进行了回顾性研究。通过放射学检查，根据托姆茨分类法将跟骰关节半脱位分为I至IV级。尽管没有统计数据证实，但该分级与总体畸形有一定相关性。术后，I级足患者仅行后路松解或后内侧松解似乎就能获得满意效果。II - III级足通常需要广泛的后内侧和外侧松解。行跟骰关节松解和复位的患者比未行该操作的患者矫正效果更好。我们得出结论，术前应评估跟骰关节半脱位情况，并在手术中进行复位，以取得良好效果。
