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脑瘫患儿的足部畸形

Foot deformities in children with cerebral palsy.

作者信息

Kedem Paz, Scher David M

机构信息

aDepartment of Orthopaedic Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel bDepartment of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, NYC, New York, USA.

出版信息

Curr Opin Pediatr. 2015 Feb;27(1):67-74. doi: 10.1097/MOP.0000000000000180.

Abstract

PURPOSE OF REVIEW

The present article describes common foot deformities in children with cerebral palsy and discusses treatment options for each of those deformities.

RECENT FINDINGS

Bracing is a useful treatment to correct foot deformities during gait. Surgical correction of foot deformities is typically performed as a part of multilevel single-event gait improvement surgery that has increasingly become the standard of care for ambulatory children with cerebral palsy. Foot realignment may improve knee function during stance, probably because of change of lever arm.

SUMMARY

Foot deformities are common among children with cerebral palsy. The three most common among them are equinus, planovalgus and equinovarus/equinocavovarus. Treatment consists of orthotics, physical therapy, spasticity reduction treatment and surgical correction. Guidelines for treatment are individualized and multifactorial. Important considerations include the child's level of function, the severity and flexibility of the deformity, the presence or absence of pain and skin irritation, and the changes in alignment observed over time.

摘要

综述目的

本文描述了脑瘫患儿常见的足部畸形,并讨论了针对每种畸形的治疗选择。

最新发现

支具是纠正步态中足部畸形的一种有效治疗方法。足部畸形的手术矫正通常作为多阶段单事件步态改善手术的一部分进行,该手术已越来越成为能行走的脑瘫患儿的标准治疗方法。足部重新排列可能会改善站立期的膝关节功能,这可能是由于力臂的改变。

总结

足部畸形在脑瘫患儿中很常见。其中最常见的三种是马蹄足、扁平外翻足和马蹄内翻足/马蹄空凹足。治疗方法包括矫形器、物理治疗、痉挛减轻治疗和手术矫正。治疗指南是个体化且多因素的。重要的考虑因素包括患儿的功能水平、畸形的严重程度和灵活性、是否存在疼痛和皮肤刺激,以及随时间观察到的排列变化。

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