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[纵行性外胚层发育不良治疗中足部的保全]

[Conservation of the foot in the treatment of longitudinal external ectromelia].

作者信息

Jawish R, Carlioz H

机构信息

Service d'Orthopédie et de Chirurgie Réparatrice de l'Enfant, Hôpital Trousseau, Paris.

出版信息

Rev Chir Orthop Reparatrice Appar Mot. 1991;77(2):115-20.

PMID:1829246
Abstract

We studied 52 congenital longitudinal deficiencies of the fibula in 44 children, 25 girls and 19 boys. We preferred equalization of leg-length discrepancy and correction of equinovalgus deformity of the foot, to amputation. Correction of the deformity in valgus and equinus is obtained at the price of the section of triceps, peroneus brevis and fibula, inserted on the calcaneum. In some cases an open osteotomy of the talocalcaneal synostosis, or an osteotomy of the lower part of the tibia are also necessary. Good correction of foot has been obtained in 62.8 per cent of cases. 39.5 per cent of children have had suitable foot for weight-bearing, with normal shoes, and 23, 25 per cent have had prosthesis for discrepancy. This procedure should be carried out in predictable discrepancies below 150 mm, whereas 89 per cent of children were saved from amputation; this latter is recommended, at early age, for more important discrepancies.

摘要

我们对44名儿童(25名女孩和19名男孩)的52例先天性腓骨纵向缺损进行了研究。我们更倾向于采用肢体长度差异均衡和足马蹄外翻畸形矫正术,而非截肢术。通过切断附着于跟骨的三头肌、腓骨短肌和腓骨来矫正外翻和马蹄畸形。在某些情况下,还需要对距跟骨联合进行开放性截骨术,或对胫骨下部进行截骨术。62.8%的病例足部得到了良好矫正。39.5%的儿童足部适合负重并能穿正常鞋子,23.25%的儿童因肢体长度差异而佩戴了假肢。该手术适用于预计差异小于150毫米的情况,89%的儿童因此避免了截肢;对于差异较大的情况,建议在儿童早期进行截肢。

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