Segal L S, Mann D C, Feiwell E, Hoffer M M
Division of Orthopaedics and Rehabilitation, Southern Illinois University School of Medicine, Springfield.
Foot Ankle. 1989 Aug;10(1):12-6. doi: 10.1177/107110078901000103.
As initial surgical management for rigid equinovarus deformities, 16 children with arthrogryposis (30 involved feet) and 16 myelodysplastic children (26 involved feet) underwent primary talectomies or extensive posterior-medial releases (PMR). When compared with primary PMRs in arthrogrypotic children, primary talectomies revealed a greater number of good and fair results, decreased recurrence rates, less procedures per foot, and maintenance of ambulatory status. Recurrent forefoot and cavus deformities were present after primary talectomies. Primary talectomy in arthrogrypotic children was more effective than posterior-medial releases or secondary (salvage) talectomy. Because of the small number of feet involved, the role of primary talectomy in myelomeningocele was not clarified by this study. Radical PMRs in myelodysplastic children resulted in a significant number of hindfoot valgus deformities that required secondary procedures.
作为僵硬马蹄内翻畸形的初始手术治疗方法，16例患有先天性多发性关节挛缩症的儿童（30只患足）和16例脊髓发育不良的儿童（26只患足）接受了一期距骨切除术或广泛的后内侧松解术（PMR）。与先天性多发性关节挛缩症儿童的一期PMR相比，一期距骨切除术显示出更多良好和中等的结果、更低的复发率、每只足更少的手术次数以及行走状态的维持。一期距骨切除术后出现复发性前足和高弓足畸形。先天性多发性关节挛缩症儿童的一期距骨切除术比后内侧松解术或二期（挽救性）距骨切除术更有效。由于患足数量较少，本研究未阐明一期距骨切除术在脊髓脊膜膨出中的作用。脊髓发育不良儿童的根治性PMR导致大量后足外翻畸形，需要二期手术。
