Lee Mark C, Sucato Daniel J
Department of Orthopaedic Surgery, University of Texas at Southwestern Medical Center, TX 75219, USA.
Foot Ankle Clin. 2008 Jun;13(2):199-219, v. doi: 10.1016/j.fcl.2008.01.002.
Cavovarus foot deformity in children has numerous etiologies with a general pathophysiologic mechanism of muscle imbalance. It is of great importance in the evaluation of a child with a cavovarus foot to determine the underlying cause of the deformity, as the most common origin is a progressive neurologic condition that may be complicated by other orthopedic problems. Treatment options typically are surgical, with limited indications for nonsurgical modalities, and must consider the age of the patient, the nature of the neurologic disease, and the severity of the deformity. Current surgical procedures can be divided into soft tissue procedures to rebalance the muscle forces, osteotomies, and triple arthrodesis. Triple arthrodesis is considered a salvage procedure reserved for the older child with severe, rigid deformity who has failed other surgical treatments.
儿童高弓内翻足畸形有多种病因，其一般病理生理机制为肌肉失衡。对于患有高弓内翻足的儿童进行评估时，确定畸形的潜在原因非常重要，因为最常见的病因是一种进行性神经疾病，可能会并发其他骨科问题。治疗选择通常是手术治疗，非手术方式的适应证有限，并且必须考虑患者的年龄、神经疾病的性质以及畸形的严重程度。目前的外科手术可分为软组织手术以重新平衡肌力、截骨术和三关节融合术。三关节融合术被认为是一种挽救性手术，适用于其他手术治疗失败的严重、僵硬畸形的大龄儿童。
