Sherk H H, Marchinski L J, Clancy M, Melchonni J
Myelomeningocele Clinic, Children's Hospital of Philadelphia 19129.
J Pediatr Orthop. 1989 May-Jun;9(3):269-75.
Results of talectomies in 19 patients with severe foot deformities secondary to myelomeningocele were evaluated with an average follow-up of 12 years, 7 months. Although an apparently plantigrade foot was usually obtained, talectomy rarely succeeded in distributing weightbearing forces uniformly over the plantar surface. Photoelastic force-plate analysis incorporating three-dimensional contour mapping clearly identified areas of high ground-foot reaction forces (GFRs) and high-pressure gradients. We suggest that such high-pressure areas predispose these patients to neurotrophic ulceration.
对19例因脊髓脊膜膨出继发严重足部畸形而行距骨切除术的患者进行了评估，平均随访时间为12年7个月。尽管通常能获得外观上足底着地的足部，但距骨切除术很少能成功地将负重力量均匀地分布在足底表面。结合三维轮廓映射的光弹力板分析清楚地确定了高足底-地面反作用力（GFRs）区域和高压梯度区域。我们认为，这些高压区域使这些患者易患神经营养性溃疡。
