Eberhardt Oliver, Fernandez Francisco F, Gabriel Heinz, Wirth Thomas, Fuchs-Winkelmann Susanne, Peterlein Christian D
aOrthopaedic Department, Olgahospital, Stuttgart bInstitute for Clinical Genetic Klinikum Stuttgart, Stuttgart, Germany cDepartment of Orthopaedics and Rheumatology, University Hospital Gieβen and Marburg, Marburg, Germany.
J Pediatr Orthop B. 2014 Nov;23(6):505-11. doi: 10.1097/BPB.0000000000000084.
We report on three children with bilateral, congenital clubfoot. Four of the six clubfeet were associated with preaxial polydactyly. Five of the six clubfeet were treated without extensive surgery. A plantigrade foot was achieved, even in the three clubfeet with polydactyly, using serial casting and percutaneous Achilles tenotomy. Casting was adapted according to the existing polydactyly. One case with tibial hemimelia and a complex clubfoot deformity with preaxial tarsal polydactyly required more comprehensive surgery. A foot with good weight-bearing function was also achieved in this case following resection of the accessory medial ray, including resection of the accessory tarsal bones and posterior release. Remaining limitations in mobility were ascribed to hindfoot pathologies.
我们报告了三名患有双侧先天性马蹄内翻足的儿童。六只马蹄内翻足中有四只与轴前多指畸形相关。六只马蹄内翻足中有五只未经广泛手术治疗。通过连续石膏固定和经皮跟腱切断术，即使是三只患有多指畸形的马蹄内翻足也实现了足底着地。石膏固定根据现有的多指畸形进行调整。一名患有胫骨半肢畸形和伴有轴前跗骨多指畸形的复杂马蹄内翻足畸形的病例需要更全面的手术。在切除副内侧射线，包括切除副跗骨和后路松解后，该病例也获得了具有良好负重功能的足部。活动度的剩余限制归因于后足病变。
