Hallaj-Moghaddam Mohammad, Moradi Ali, Ebrahimzadeh Mohammad Hosein, Habibzadeh Shojaie Seyed Reza
Orthopedic Research Center, Mashhad University of Medical Science, Mashhad 91766-99199, Iran.
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Adv Orthop. 2015;2015:821690. doi: 10.1155/2015/821690. Epub 2015 Feb 10.
Between 2007 and 2010, a prospective study was done on 85 patients with severe idiopathic nonsyndromic clubfeet, in our center. Demographic features, severity of the deformity before and after serial casting according to Diméglio classification, and complications were assessed. The mean age of the patients was 8 days and 69% were male. The mean follow-up period was 26 months. The average number of castings used to correct the deformity was 5.7 times (range: 4 to 8). Tenotomy was performed in 76 (89.4%) of the feet. In all patients, plantigrade foot was achieved. Tenotomy occurred more in patients with higher Diméglio scores. Although patients who underwent Achilles tenotomy began to walk later than those who did not (13 ± 7.2 versus 9.2 ± 18), it was not significant (P = 0.06). Relapse rate, at the end of follow-up, was 27.1%. Diméglio score before casting was 16 ± 3.4 and at the end of follow-up it was 1.6 ± 6.2. The patients with bilateral clubfeet had inferior final outcome compared to those with unilateral clubfoot. Eighty percent of parents' were completely satisfied with their child's gait and foot appearance (94.1%). Ponseti method of manipulation and casting is a valuable technique in severe club foot as well as in common types.
2007年至2010年期间，我们中心对85例重度特发性非综合征性马蹄内翻足患者进行了一项前瞻性研究。评估了人口统计学特征、根据Diméglio分类法在系列石膏固定前后的畸形严重程度以及并发症情况。患者的平均年龄为8天，69%为男性。平均随访期为26个月。用于矫正畸形的石膏平均使用次数为5.7次（范围：4至8次）。76只（89.4%）脚进行了跟腱切断术。所有患者均实现了足跟着地。跟腱切断术在Diméglio评分较高的患者中更为常见。尽管接受跟腱切断术的患者开始行走的时间比未接受该手术的患者晚（13±7.2天对9.2±1.8天），但差异无统计学意义（P = 0.06）。随访结束时的复发率为27.1%。石膏固定前的Diméglio评分为16±3.4，随访结束时为1.6±6.2。双侧马蹄内翻足患者的最终结果比单侧马蹄内翻足患者差。80%的家长对孩子的步态和足部外观完全满意（94.1%）。庞塞蒂手法和石膏固定法在重度马蹄内翻足以及常见类型中都是一种有价值的技术。
