Hootnick D R, Packard D S, Levinsohn E M
Department of Anatomy, State University of New York Health Science Center, Syracuse 13210.
Foot Ankle. 1990 Jun;10(6):312-6. doi: 10.1177/107110079001000605.
Amputation after clubfoot surgery is a rare and catastrophic complication. This case report involves an amputation necessitated by postoperative necrosis on the medial side of the foot. To our knowledge, only one brief published report of necrosis following clubfoot surgery exists in the literature, and that report contains little clinical information. Although we know of several additional cases of necrosis following clubfoot surgery, the details of these cases remain unavailable to us for publication. The clubfoot deformity is almost always associated with vascular deficiencies involving the anterior tibial and dorsalis pedis arteries, as well as their derivatives. Since the area of necrosis in this case report coincided with the anatomic distribution of the derivatives of the congenitally reduced or absent dorsalis pedis artery, we suggest that insufficient blood flow to the dorsal and medial sides of the foot, and to the hallux contributed to the necrosis. In our opinion, the surgeon should assume that an abnormal vascular pattern, as described here, is present unless proven otherwise.
马蹄足手术后截肢是一种罕见且严重的并发症。本病例报告涉及因足部内侧术后坏死而导致的截肢。据我们所知，文献中仅有一篇关于马蹄足手术后坏死的简短发表报告，且该报告几乎没有临床信息。尽管我们知晓还有几例马蹄足手术后坏死的病例，但这些病例的详细情况我们无法获取以进行发表。马蹄足畸形几乎总是与胫前动脉和足背动脉及其分支的血管缺陷相关。由于本病例报告中的坏死区域与先天性发育不良或缺失的足背动脉分支的解剖分布一致，我们认为足部背侧和内侧以及拇趾的血流不足是导致坏死的原因。我们认为，除非另有证明，外科医生应假定存在此处所描述的异常血管模式。
