Department of Orthopaedics Surgery, Asan Medical Center University of Ulsan College of Medicine, Seoul, Republic of Korea.
Foot Ankle Int. 2012 Dec;33(12):1075-8. doi: 10.3113/FAI.2012.1075.
Regardless of the mode of treatment, clubfoot has a strong tendency to relapse, especially hindfoot equinus. Because contraction or shortening of the Achilles tendon causes an equinus deformity of the ankle, release of this tendon is required to correct equinus deformity in patients with residual or relapsed clubfoot. This study assessed the effectiveness of the Vulpius technique in correcting equinus deformity in patients with residual or relapsed clubfoot.
Of the 80 idiopathic clubfeet treated conservatively using the Ponseti protocol, between March 2000 and July 2008, 32 were found to have residual or relapsed equinus deformity, with 22 feet in 17 patients undergoing Vulpius-type Achilles tendon lengthening. Mean age at the time of surgery was 29 (range, 6 to 52) months, and mean follow-up was 48 (range, 24 to 78) months. Clinical evaluation included the dorsiflexion angle of the ankle and radiographic evaluation included the talocalcaneal and tibiocalcaneal angles on dorsiflexion lateral views.
All 22 feet showed satisfactory results at last follow-up, with significant improvements in mean ankle dorsiflexion angle, mean tibiocalcaneal angle, and mean lateral talocalcaneal angle (p < .05 each).
The Vulpius procedure is an effective surgical procedure for correcting equinus deformity in residual and relapsed clubfeet.
无论采用何种治疗方式，马蹄足都有很强的复发倾向，尤其是后足马蹄内翻。由于跟腱的挛缩或缩短导致踝关节马蹄内翻畸形，因此需要对残余或复发的马蹄足患者释放跟腱以矫正马蹄内翻畸形。本研究评估了 Vulpius 技术矫正残余或复发马蹄足患者马蹄内翻畸形的疗效。
2000 年 3 月至 2008 年 7 月，采用 Ponseti 方案对 80 例特发性马蹄足进行了保守治疗，发现 32 例存在残余或复发的马蹄内翻畸形，其中 17 例患者的 22 足接受了 Vulpius 型跟腱延长术。手术时的平均年龄为 29 个月（范围，6 至 52 个月），平均随访时间为 48 个月（范围，24 至 78 个月）。临床评估包括踝关节背屈角度，影像学评估包括背屈侧位片上的距跟骨和跟距骨角度。
末次随访时，所有 22 足均获得满意结果，平均踝关节背屈角度、平均跟距骨角度和平均外侧距跟骨角度均显著改善（p <.05 ）。
Vulpius 手术是矫正残余和复发马蹄足马蹄内翻畸形的有效手术方法。
