Sanzarello Ilaria, Nanni Matteo, Faldini Cesare
aDepartment of Orthopaedic and Traumatology, University of Messina, Messina bRizzoli-Sicilia Department, Rizzoli Orthopedic Institute, Bagheria (PA) cOrthopedic and Trauma Clinic-Department I, University of Bologna, Rizzoli Orthopedic Institute, Bologna, Italy.
J Pediatr Orthop B. 2017 Mar;26(2):143-151. doi: 10.1097/BPB.0000000000000350.
The aim of this paper is to review all treatment methods of the clubfoot over the years through the documentation present in the literature and art with the aim of better understanding the pathoanatomy of the deformity, but to also clarify factors that allow a safe, logical approach to clubfoot management. The initial part of this paper traces the most representative iconographic representations of clubfoot in history to describe how his presence was witnessed since ancient times. Hippocrates, the father of medicine, was the first to present written references about treatment methods of clubfoot. After the dark period of the Middle Ages, during the Renaissance, there were more detailed studies on the disease, with the creation of the first orthopedic orthotics, designed to correct the deformity with the help of famous names in medicine's history. In the XVIII century, as we witness the birth of orthopedics as a distinct discipline in medicine, more and more brilliant minds developed complex orthoses and footwear with the aim of obtaining a proper correction of the deformity. In the last part of the paper, there is a description of the main surgical techniques developed over the years until the return to conservative treatment methods such as the Ponseti method, internationally recognized as the gold standard of treatment, despite the presence of some unresolved issues such as the possible recurrence of the disease.
本文旨在通过文献和艺术作品中的记载回顾多年来马蹄内翻足的所有治疗方法，以便更好地理解畸形的病理解剖结构，同时也阐明有助于安全、合理地处理马蹄内翻足的因素。本文开篇追溯了历史上最具代表性的马蹄内翻足图像，以描述自古以来人们是如何见证其存在的。医学之父希波克拉底是第一个提出关于马蹄内翻足治疗方法书面参考的人。在中世纪的黑暗时期之后，文艺复兴时期对该疾病有了更详细的研究，并制造出了第一批矫形支具，旨在借助医学史上的知名人士来矫正畸形。在18世纪，随着我们见证矫形外科学作为医学中一门独立学科的诞生，越来越多杰出的人才开发出了复杂的矫形器和鞋具，旨在实现对畸形的适当矫正。在本文的最后部分，描述了多年来发展起来的主要手术技术，直到回归到保守治疗方法，如庞塞蒂方法，尽管存在一些未解决的问题，如疾病可能复发，但该方法在国际上被公认为治疗的金标准。
