Roessingh Rehabilitation Center, Stroke Unit, Roessinghbleekweg 33, NL-7522 AH Enschede, The Netherlands.
J Rehabil Med. 2012 Jul;44(8):614-23. doi: 10.2340/16501977-1012.
Equinovarus foot deformity following stroke or traumatic brain injury compromises walking capacity, interfering with activities of daily living. In soft-tissue surgery the imbalanced muscles responsible for the deviant position of the ankle and foot are lengthened, released and/or transferred. However, knowledge about the effectiveness of surgical correction is limited. The aim of the present study was to carry out a systematic review of the literature to assess the effects of surgical correction of equinovarus foot deformity in patients with stroke or traumatic brain injury.
A systematic search of full-length articles in the English, German or Dutch languages published from 1965 to March 2011 was performed in PubMed, EMBASE, CINAHL, Cochrane and CIRRIE. The identified studies were analysed following the International Classification of Functioning, Disability and Health criteria.
A total of 15 case series, case control and historically controlled studies (CEBM level 4) were identified, suggesting that surgical correction of equinovarus foot deformity is a safe procedure that is effective in terms of re-obtaining a balanced foot position, improving walking capacity and diminishing the need for orthotic use.
Further validation of surgical correction of equinovarus foot deformity following stroke or traumatic brain injury is required, using higher level study designs with validated assessment tools. Comparing surgical techniques with other interventions is necessary to generate evidence upon which treatment algorithms could be based.
脑卒中或颅脑损伤后出现的马蹄内翻足畸形会影响步行能力，从而影响日常生活活动。在软组织手术中，通过延长、松解和/或转移导致踝关节和足部畸形的失衡肌肉来矫正畸形。但是，目前对于手术矫正效果的相关知识还很有限。本研究旨在对脑卒中或颅脑损伤后马蹄内翻足畸形的手术矫正效果进行系统评价。
检索 1965 年至 2011 年 3 月间在 PubMed、EMBASE、CINAHL、Cochrane 和 CIRRIE 中发表的英文、德文或荷兰文全文文献，采用国际功能、残疾和健康分类标准进行分析。
共纳入 15 项病例系列、病例对照和历史性对照研究（CBM 分级 4 级），提示手术矫正脑卒中或颅脑损伤后马蹄内翻足畸形是一种安全的方法，能够有效恢复足部平衡位置，改善步行能力，减少矫形器的使用。
需要采用具有验证评估工具的更高等级研究设计来进一步验证手术矫正脑卒中或颅脑损伤后马蹄内翻足畸形的效果。比较手术技术与其他干预措施的效果，可为治疗方案的制定提供依据。
