Kránicz J, Trombitás K, Szabó G
Department of Orthopedics, University Medical School, Pécs, Hungary.
Orthopedics. 1991 Jan;14(1):73-5. doi: 10.3928/0147-7447-19910101-13.
Open biopsies were carried out on the muscles of 23 clubfoot patients, ages 9 months to 4 years. Electron microscopic analyses of the so-called "clubfoot muscles" and the peroneal muscles were performed. The changes found were not present in every area of the muscles, but were surrounded by fields of normal structure. Fatty degeneration with fibrosis was observed as the consequence of immobilization. More marked loss was found in the contractile elements. The authors believe that neuromuscular atrophy is a primary cause of congenital clubfoot. The most seriously affected muscles in this study were the tibialis posterior and peroneal muscles. The material failed to prove correlation with age. Based on their observations, the authors suggest finishing all types of immobilization before 1 year of age, when children begin to walk.
对23例年龄在9个月至4岁之间的马蹄足患者的肌肉进行了开放性活检。对所谓的“马蹄足肌肉”和腓骨肌进行了电子显微镜分析。发现的变化并非存在于肌肉的每个区域，而是被正常结构的区域所包围。观察到固定导致脂肪变性伴纤维化。在收缩元件中发现了更明显的损失。作者认为神经肌肉萎缩是先天性马蹄足的主要原因。本研究中受影响最严重的肌肉是胫后肌和腓骨肌。该材料未能证明与年龄相关。基于他们的观察，作者建议在儿童开始行走的1岁之前完成所有类型的固定。
