Matar Hosam E, Beirne Peter, Garg Neeraj
Department of Trauma and Orthopaedics, Alder Hey's Hospital, Eaton Road, Liverpool, L12 2AP, UK.
J Child Orthop. 2016 Feb;10(1):15-8. doi: 10.1007/s11832-016-0712-1. Epub 2016 Jan 30.
To evaluate the effectiveness of the Ponseti method in treating clubfoot associated with arthrogryposis.
Retrospective consecutive review over a 10-year period in a tertiary centre of all patients with arthrogrypotic clubfoot treated with the Ponseti method. The primary outcome measure at final follow-up was the functional correction of the deformity.
There were ten children with 17 arthrogrypotic clubfeet, with an average follow-up of 5.8 years (range 3-8 years). The average age at presentation was 5 weeks (range 2-20 weeks). Deformities were severe, with an average Pirani score of 5.5 (range 3-6). Initial correction was achieved in all children with an average of 8 (range 4-10) Ponseti casts and a tendo-Achilles tenotomy (TAT) was performed in 94.1 %. Two-thirds of patients had a satisfactory outcome at final follow-up, with functional plantigrade, pain-free feet.
The Ponseti method is an effective first-line treatment for arthrogrypotic clubfeet to achieve functional plantigrade feet. Children will often require more casts and have a higher risk of relapse.
评估庞塞蒂方法治疗与先天性多发性关节挛缩症相关的马蹄内翻足的有效性。
在一家三级医疗中心对所有采用庞塞蒂方法治疗的先天性多发性关节挛缩症马蹄内翻足患者进行为期10年的回顾性连续研究。最终随访时的主要结局指标是畸形的功能矫正。
共有10名儿童，17只先天性多发性关节挛缩症马蹄内翻足，平均随访5.8年（范围3 - 8年）。就诊时的平均年龄为5周（范围2 - 20周）。畸形严重，平均皮拉尼评分为5.5（范围3 - 6）。所有儿童均实现了初始矫正，平均使用8个（范围4 - 10个）庞塞蒂石膏，94.1%的患儿进行了跟腱切断术（TAT）。三分之二的患者在最终随访时获得了满意的结果，足部功能为跖行、无痛。
庞塞蒂方法是治疗先天性多发性关节挛缩症马蹄内翻足以实现足部功能跖行的有效一线治疗方法。儿童通常需要更多石膏，且复发风险更高。
