Brodsky James W
Foot and Ankle Surgery Fellowship Program, Baylor University Medical Center, Dallas, TX 75246, USA.
Foot Ankle Clin. 2010 Jun;15(2):287-96. doi: 10.1016/j.fcl.2010.03.002.
There are limited studies about the incidence, nature, and severity of symptoms in adults with treated clubfoot; the rate at which symptoms increase and function diminishes with advancing age; and the appropriate treatments. One of the principles of treatment of these patients includes recognition that no one description of deformities applies to all cases of painful deformity in adults after childhood treatment of congenital clubfoot. There is a spectrum of the types of deformity and a range of severity among these that must be taken into account in the decision making regarding treatment. Although the level of symptoms is very variable and ankle and hindfoot arthrodeses have the disadvantage of increasing mechanical stress and subsequent arthritis in the midfoot, arthrodesis and, to a lesser degree, osteotomy remain the mainstays of surgical reconstruction in the adult with painful deformity after treatment of congenital talipes equinovarus.
关于接受过治疗的成人马蹄内翻足的发病率、症状性质和严重程度，症状随年龄增长而加重以及功能减退的速率，还有适当的治疗方法，相关研究有限。治疗这些患者的原则之一是认识到，对于童年期先天性马蹄内翻足治疗后成人出现的疼痛性畸形，没有一种畸形描述适用于所有病例。畸形类型存在一系列变化，且严重程度各异，在制定治疗决策时必须予以考虑。尽管症状程度差异很大，且踝关节和后足关节融合术存在增加中足机械应力及后续关节炎的缺点，但关节融合术以及程度较轻的截骨术仍是先天性马蹄内翻足治疗后出现疼痛性畸形的成人手术重建的主要方法。
