Eberhardt O, Wirth T, Fernandez F F
Orthopädische Klinik, Olgahospital Stuttgart, Bismarckstr. 8, 70176, Stuttgart, Deutschland,
Orthopade. 2013 Dec;42(12):1001-7. doi: 10.1007/s00132-012-2047-z.
In the last decade treatment of foot deformities has changed from extensive surgery to casting and minimally invasive surgery. The Ponseti method has become the most preferred treatment for clubfoot deformities and early evaluations showed promising results. Mid-term results for idiopathic clubfoot revealed the need for additional surgery by anterior tibial tendon transfer in 11-32% of cases depending on the duration of bracing. Anterior tibial tendon transfer is the most important surgical procedure for relapses in the Ponseti concept. Casting, recasting in cases of relapses, bracing and anterior tibial tendon transfer altogether represent the Ponseti method and cannot be considered as single entities.The Dobbs method is a new concept for the treatment of vertical talus. Treatment of vertical talus should start with the Dobbs method but in comparison to clubfoot treatment there has not been a complete change to minimally invasive treatment. Especially in non-idiopathic vertical talus cases open reduction of the talonavicular and calcaneocuboid joint are often necessary.
在过去十年中,足部畸形的治疗已从广泛的手术转变为石膏固定和微创手术。庞塞蒂方法已成为治疗马蹄内翻足畸形的最优选方法,早期评估显示出令人鼓舞的结果。特发性马蹄内翻足的中期结果表明,根据支具佩戴时间,11%至32%的病例需要通过胫骨前肌腱转移进行额外手术。在庞塞蒂理念中,胫骨前肌腱转移是复发病例最重要的外科手术。石膏固定、复发时的重新石膏固定、支具治疗以及胫骨前肌腱转移共同构成了庞塞蒂方法,不能将它们视为单一的个体。多布斯方法是治疗垂直距骨的新概念。垂直距骨的治疗应从多布斯方法开始,但与马蹄内翻足治疗相比,尚未完全转变为微创治疗。特别是在非特发性垂直距骨病例中,距舟关节和跟骰关节的切开复位通常是必要的。