Karol Lori A, O'Brien Shana E, Wilson Holly, Johnston Charles E, Richards B Stephen
Texas Scottish Rite Hospital for Children, Dallas, Texas, USA.
J Pediatr Orthop. 2005 Mar-Apr;25(2):236-40. doi: 10.1097/01.bpo.0000150815.56790.b0.
Ninety children between the ages of 2 and 3 years with 127 clubfeet underwent gait analysis. Fifty-one feet had undergone posteromedial releases, 52 feet had no surgery following correction of the deformity using the French physical therapy program, and 24 feet had either tendo Achilles lengthening or posterior releases following physical therapy. Persistent internal rotation of the foot during gait was the most frequent gait disturbance and was seen in all treatment groups. Limited ankle dorsiflexion was most common in the nonoperated feet, while calcaneus deformity occurred in the posteromedial release group. Ankle motion during gait was normal in 54% of nonoperated feet compared with 39% of feet that had posteromedial releases. While gait abnormalities were common in all clubfeet, fewer deviations were documented in feet treated with physical therapy that did not require surgery. Aggressive release leads to a higher likelihood of abnormal ankle motion and internal rotation during gait.
对90名年龄在2至3岁、患有127只马蹄内翻足的儿童进行了步态分析。51只脚接受了后内侧松解术，52只脚在使用法国物理治疗方案矫正畸形后未进行手术，24只脚在物理治疗后进行了跟腱延长术或后路松解术。步态期间足部持续内旋是最常见的步态障碍，在所有治疗组中均可见。踝关节背屈受限在未手术的足部最为常见，而跟骨畸形出现在后内侧松解组。与接受后内侧松解术的足部的39%相比，54%的未手术足部在步态期间踝关节活动正常。虽然步态异常在所有马蹄内翻足中都很常见，但在不需要手术的物理治疗足部中记录到的偏差较少。积极的松解术会导致步态期间踝关节异常活动和内旋的可能性更高。
