Döderlein L
Abteilung Orthopädie und Rehabilitation, Stiftung Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
Orthopade. 2004 Oct;33(10):1152-62. doi: 10.1007/s00132-004-0683-7.
Any surgical treatment of spastic foot deformities must be preceded by an exact preoperative analysis of every aspect of the deformity and its functional consequences. The goals of surgical treatment are correction of the deformity, reestablishment of the stability of the foot and preservation of functionally important ranges of motion and muscle strength. These goals can usually be achieved only by a package of several simultaneous procedures. The foot must never be treated in isolation. Proximal joints have to be considered as well as the opposite side, because a plantigrade position of the foot is only possible when the leg is straight. Any postoperative evaluation must also take into account the proximal joints and the opposite leg in unilateral cases. The mere static evaluation of the postoperative results by reporting clinical and radiographic values should be supplemented by dynamic measurements which allow more insight into the functional results.
任何痉挛性足部畸形的手术治疗都必须在术前对畸形的各个方面及其功能后果进行精确分析。手术治疗的目标是矫正畸形、重建足部稳定性以及保留功能重要的活动范围和肌肉力量。这些目标通常只有通过一系列同时进行的手术才能实现。绝不能孤立地治疗足部。必须考虑近端关节以及对侧,因为只有当腿部伸直时,足部才能处于跖屈位。在单侧病例中,任何术后评估也必须考虑近端关节和对侧腿部。通过报告临床和影像学值对术后结果进行单纯的静态评估,应辅以动态测量,以便更深入地了解功能结果。