Farsetti Pasquale, De Maio Fernando, Russolillo Laura, Ippolito Ernesto
Department of Orthopaedic Surgery, University of Rome Tor Vergata, Rome, Italy.
Clin Orthop Relat Res. 2009 May;467(5):1243-9. doi: 10.1007/s11999-008-0699-0. Epub 2009 Feb 4.
In congenital clubfoot, residual deformities are not well-documented and they may change depending on different treatments. To identify the treatment that provides better outcome at maturity, we studied the computed tomography of two cohorts of patients affected with congenital clubfoot who were treated using two distinct protocols. Forty-seven clubfeet were treated according to the traditional protocol of our hospital and 61 were treated according to the Ponseti technique. The normal feet of the unilateral deformities served as controls. All patients were followed to skeletal maturity. The ankle torsion angle and the declination angle of the neck of the talus were higher than normal but different only in patients treated with the traditional method. The calcaneocuboid angle was lower but only in patients treated with the Ponseti method. The shape of the talar joints was altered in many feet regardless of protocol. The CT images suggest the modifications of the torsion angle of the ankle, the declination angle of the neck of the talus, and the calcaneocuboid angle at maturity are related to the treatment protocol followed. The Ponseti manipulative technique provided better anatomical results in comparison to our traditional technique.
在先天性马蹄内翻足中，残余畸形的记录并不完善，且可能因不同治疗方法而有所变化。为了确定在骨骼成熟时能提供更好治疗效果的方法，我们研究了两组接受不同治疗方案的先天性马蹄内翻足患者的计算机断层扫描结果。47例马蹄内翻足按照我院传统方案治疗，61例按照庞塞蒂技术治疗。单侧畸形患者的正常足作为对照。所有患者均随访至骨骼成熟。踝关节扭转角和距骨颈倾斜角高于正常，但仅在接受传统方法治疗的患者中存在差异。跟骰角较低，但仅在接受庞塞蒂方法治疗的患者中出现。无论采用何种方案，许多足部的距骨关节形状都发生了改变。CT图像显示，成熟时踝关节扭转角、距骨颈倾斜角和跟骰角的改变与所采用的治疗方案有关。与我们的传统技术相比，庞塞蒂手法技术提供了更好的解剖学效果。
