van Bosse Harold Jacob Pieter
Department of Orthopaedic Surgery, Shriners Hospital for Children, 3551 North Broad Street, Philadelphia, PA 19140, USA.
Foot Ankle Clin. 2015 Dec;20(4):619-44. doi: 10.1016/j.fcl.2015.07.010. Epub 2015 Oct 21.
Treatment of myelomeningocele and arthrogrypotic foot deformities has been controversial; many different procedures have been advocated for each type of deformity. In most cases, outcomes have had variable success rates, and many complications can occur. Treatment strategies should highlight care that avoids the development of a stiffened foot and allows for a variety of options to regain correction when a relapse occurs. This is particularly true in myelomeningocele, whereby a stiff foot runs a high risk for skin ulceration, leading to osteomyelitis. Discussion includes appropriate circumstances for the use of presented procedures and the author's preferred treatment for each deformity.
脊髓脊膜膨出和先天性多发性关节挛缩症足部畸形的治疗一直存在争议;针对每种畸形类型都提倡采用许多不同的手术方法。在大多数情况下,治疗结果的成功率各不相同,并且可能会出现许多并发症。治疗策略应着重于避免足部僵硬的护理,并在复发时提供多种恢复矫正的选择。这在脊髓脊膜膨出症中尤为如此,因为僵硬的足部发生皮肤溃疡并导致骨髓炎的风险很高。讨论内容包括所介绍手术方法的适用情况以及作者对每种畸形的首选治疗方法。