Noritake Koji, Yoshihashi Yuji, Miyata Toru
Department of Orthopaedic Surgery, Aichi Prefectural Hospital, Habilitation Center for Disabled Children, Dai-ni Aoitori Gakuen, Okazaki City, Japan.
J Pediatr Orthop B. 2005 Jul;14(4):274-9. doi: 10.1097/01202412-200507000-00008.
The purpose of this study was to evaluate the effectiveness of calcaneal lengthening in the treatment of planovalgus foot deformity of children with spastic cerebral palsy. Sixteen children (27 feet) with spastic cerebral palsy underwent calcaneal lengthening along with peroneal tendons. The results were assessed clinically and radiographically. Over an average of 3.2 years of follow-up (2.0-5.0), 20 (74.1%) feet showed a satisfactory clinical result, and 21 (77.8%) feet showed a satisfactory radiographic result, according to the modified Mosca's criteria. Dependent ambulators with severe pes planovalgus showed unsatisfactory results compared with independent ambulators with mild to moderate pes planovalgus. These findings suggest that for severe pes planovalgus of children with cerebral palsy, it may be difficult to correct the foot deformity by calcaneal lengthening with peroneal tendons.
本研究的目的是评估跟骨延长术治疗痉挛性脑瘫患儿扁平外翻足畸形的有效性。16例痉挛性脑瘫患儿(27足)接受了跟骨延长术及腓骨肌腱手术。通过临床和影像学评估结果。根据改良的莫斯卡标准,平均随访3.2年(2.0 - 5.0年),20足(74.1%)临床结果满意,21足(77.8%)影像学结果满意。与轻度至中度扁平外翻足的独立行走者相比,重度扁平外翻足的依赖行走者结果不满意。这些发现表明,对于脑瘫患儿的重度扁平外翻足,通过跟骨延长术及腓骨肌腱手术可能难以矫正足部畸形。