Radler C, Mindler G T
Abteilung für Kinderorthopädie und Fußchirurgie, Orthopädisches Spital Speising GmbH, Speisinger Str. 109, 1130, Wien, Österreich.
Orthopade. 2016 Oct;45(10):909-24. doi: 10.1007/s00132-016-3319-9.
Over the last 10 years the Ponseti method has become established as the gold standard for initial treatment of clubfeet nearly worldwide. Nevertheless, there are considerable fluctuations regarding the authenticity and quality in the application of the Ponseti method. Especially the efforts to ensure and promote compliance with the foot abduction brace and subsequently the recurrence rate show great variation. As a result, we are still faced with a significant number of recurrent or residual clubfeet. In recent years it has been shown in high-volume clinics that even these can almost always be successfully treated with recasting and with minor interventions, such as anterior tibial tendon transfer and lengthening of the Achilles tendon. More invasive surgical procedures are only very rarely indicated and are reserved for severe recurrence in previously surgically treated and secondary clubfeet.
在过去10年里,庞塞蒂方法已成为全球范围内几乎所有先天性马蹄内翻足初始治疗的金标准。然而,在庞塞蒂方法的应用中,其准确性和质量存在相当大的波动。特别是在确保和促进使用足部外展支具方面的努力以及随后的复发率差异很大。因此,我们仍然面临着大量复发性或残留性马蹄内翻足病例。近年来,在大型诊所中已表明,即使是这些病例,几乎总能通过重新塑形以及诸如胫前肌腱转移和跟腱延长等小手术成功治疗。更具侵入性的外科手术很少被采用,仅用于既往接受过手术治疗的严重复发性和继发性马蹄内翻足。