Ettl V, Kirschner S, Krauspe R, Raab P
Department of Orthopaedics, Julius-Maximilians University Wuerzburg, Wuerzburg, Germany.
Int Orthop. 2009 Apr;33(2):515-20. doi: 10.1007/s00264-007-0495-6. Epub 2007 Dec 20.
Relapse rates of surgically treated clubfeet are about 25%. We reviewed 43 patients (57 feet) treated for relapsed clubfoot deformity between 1992 and 2001 in our department. The average age of the patients at the time of revision surgery was 5.1 years, the mean follow-up was 6.6 years. Surgical therapy was performed using an algorithm according to age groups. The mean Atar score at follow-up was 77 points, representing a good outcome. Out of 57 feet, 20 (35%) were rated excellent, 24 (42%) good, 5 (9%) fair, and 8 (14%) poor. The number of previous surgical interventions had no influence on the outcome. Using an age related surgical algorithm, good postoperative results could be achieved in most of our patients, thus improving their functional situation. This emphasises the usefulness of the proposed algorithm in the difficult situation of recurrent clubfoot, while thorough analysis of the underlying deformity remains essential.
手术治疗马蹄内翻足的复发率约为25%。我们回顾了1992年至2001年间在我科接受复发性马蹄内翻足畸形治疗的43例患者（57只脚）。翻修手术时患者的平均年龄为5.1岁，平均随访时间为6.6年。根据年龄组采用一种算法进行手术治疗。随访时的平均阿塔尔评分是77分，代表良好的结果。在57只脚中，20只（35%）评为优秀，24只（42%）良好，5只（9%）尚可，8只（14%）差。既往手术干预的次数对结果没有影响。采用与年龄相关的手术算法，我们大多数患者术后都能取得良好效果，从而改善了他们的功能状况。这强调了所提出的算法在复发性马蹄内翻足这种困难情况下的有用性，同时对潜在畸形进行全面分析仍然至关重要。
