Thacker Mihir M, Scher David M, Sala Debra A, van Bosse Harold J P, Feldman David S, Lehman Wallace B
Center for Children, NYU Hospital for Joint Diseases, New York, New York, USA.
J Pediatr Orthop. 2005 Mar-Apr;25(2):225-8. doi: 10.1097/01.bpo.0000150814.56790.f9.
The purpose of this study was to evaluate the need for the use of a foot abduction orthosis (FAO) in the treatment of idiopathic clubfeet using the Ponseti technique. Forty-four idiopathic clubfeet were treated with casting using the Ponseti method followed by FAO application. Compliance was defined as full-time FAO use for 3 months and part-time use subsequently. Noncompliance was failure to fulfill the criteria during the first 9 months after casting. Feet were rated according to the Dimeglio and Pirani scoring systems at initial presentation, at the time of FAO application, and at 6 to 9 months of follow-up. At the time of application, no significant differences in scores were found between the groups. At follow-up, the compliant group's scores were significantly (P < 0.01) better than those of the noncompliant group. From the time of application to follow-up, for the compliant group, the Dimeglio scores improved significantly (P = 0.005). For the noncompliant group, the Dimeglio scores deteriorated significantly (P = 0.001). The feet of patients compliant with FAO use remained better corrected than the feet of those patients who were not compliant. Proper use of FAO is essential for successful application of the Ponseti technique.
本研究的目的是评估在使用庞塞蒂技术治疗特发性马蹄内翻足时使用足部外展矫形器（FAO）的必要性。44例特发性马蹄内翻足采用庞塞蒂方法进行石膏固定，随后应用FAO治疗。依从性定义为全时使用FAO 3个月，随后为部分时间使用。不依从定义为在石膏固定后的前9个月内未达到标准。在初次就诊时、应用FAO时以及随访6至9个月时，根据迪梅吉奥和皮拉尼评分系统对足部进行评分。在应用FAO时，两组之间的评分没有显著差异。在随访时，依从组的评分显著（P < 0.01）优于不依从组。从应用FAO到随访期间，依从组的迪梅吉奥评分显著改善（P = 0.005）。对于不依从组，迪梅吉奥评分显著恶化（P = 0.001）。使用FAO依从的患者的足部矫正效果仍然优于不依从患者的足部。正确使用FAO对于庞塞蒂技术的成功应用至关重要。
