Parnes Nata, Wientroub Shlomo, Yaniv Moshe, Segev Eitan
Department of Orthopaedics B, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Harefuah. 2007 Feb;146(2):129-33, 164.
Idiopathic clubfoot, one of the most common problems in pediatric orthopaedics, is characterized by a complex three-dimensional deformity of the foot. The treatment of clubfoot is controversial and continues to be so. Since nonsurgical management was thought not to yield adequate correction and a durable result, most children with idiopathic clubfoot have undergone surgery with extensive posteromedial and lateral release. However, surgical management caused residual deformity, stiffness, and pain in some children. Therefore, the favorable long-term results with the Ponseti and French methods of nonsurgical management have garnered interest. Today extensive surgical treatment is no longer necessary in more then 90% of congenital clubfeet. This review aims to assess the different methods of clubfoot treatment used over the years in light of an evolving understanding of the pathoanatomy of the deformity and also clarify factors that allow a safe, logical approach to clubfoot management.
特发性马蹄内翻足是小儿骨科最常见的问题之一，其特征是足部存在复杂的三维畸形。马蹄内翻足的治疗存在争议，且一直如此。由于非手术治疗被认为无法获得足够的矫正效果和持久的疗效，大多数特发性马蹄内翻足患儿都接受了广泛的后内侧和外侧松解手术。然而，手术治疗在一些患儿中导致了残留畸形、僵硬和疼痛。因此，庞塞蒂法和法国非手术治疗方法所取得的良好长期效果引起了关注。如今，超过90%的先天性马蹄内翻足已不再需要广泛的手术治疗。这篇综述旨在根据对畸形病理解剖学的不断深入认识，评估多年来使用的不同马蹄内翻足治疗方法，并阐明有助于安全、合理地治疗马蹄内翻足的因素。
