Charles Y P, Canavese F, Diméglio A
Service d'Orthopédie Pédiatrique, Hôpital Lapeyronie, Centre Hospitalier Universitaire, 371 Av. du Doyen G. Giraud, F-34295, Montpellier Cedex 5, France.
Orthopade. 2006 Jun;35(6):665-8, 670-3. doi: 10.1007/s00132-006-0955-5.
The concept of conservative clubfoot treatment beginning in the neonatal period has changed considerably in the last 2 decades. The rate of clubfeet requiring surgery (20%) and the extent of surgical interventions have dropped significantly. The early functional Montpellier method has proved to be highly effective for all degrees of deformity. It is used for patients from birth until the age of 1 year. The treatment during the first 3 months of life is decisive and consists of daily physical therapy, use of a continuous passive motion machine, and taping. This method represents an efficient alternative to the popular treatment of serial casting. Nevertheless, conservative clubfoot treatment reaches its limits as the degree of deformity increases and it should be complemented by a selective minimally invasive surgical concept. The technique is described systematically and its current value is discussed.
在过去20年里，始于新生儿期的先天性马蹄内翻足保守治疗理念发生了很大变化。需要手术治疗的马蹄内翻足比例（20%）以及手术干预的程度都显著下降。早期功能性蒙彼利埃方法已被证明对所有程度的畸形都非常有效。它适用于从出生到1岁的患者。出生后头3个月的治疗起决定性作用，包括每日物理治疗、使用持续被动运动机器和绷带固定。这种方法是流行的系列石膏固定治疗的有效替代方案。然而，随着畸形程度的增加，先天性马蹄内翻足保守治疗会达到极限，此时应辅以选择性微创外科理念。本文系统描述了该技术并讨论了其当前价值。
