Hernigou Philippe, Gravina Nicolas, Potage Damien, Dubory Arnaud
Orthopaedic Surgery, University Paris East (UPEC), Hôpital Henri Mondor, 94010, Creteil, France.
Int Orthop. 2017 Oct;41(10):2205-2212. doi: 10.1007/s00264-017-3578-z. Epub 2017 Jul 22.
Clubfoot is one of the most common congenital orthopaedic anomalies and was described by Hippocrates in the year 400 BC. From manipulation in antiquity to splint and plaster in the Renaissance the treatment had improved before tenotomy. Tenotomy was tested during the 19th century and will be explained in this manuscript; the introduction of subcutaneous tenotomy of the Achilles tendon had focused the attention of surgeons on the surgical treatment of clubfeet. While this operation was very successful in the correction of equinus deformities due to poliomyelitis, cerebral palsy, and old injuries, it was not a panacea for the patient with the congenital clubfoot. To be successful, the forefoot adduction and inversion had to be corrected completely before correction of the equinus deformity could benefit the patient. For this reason operations were extended to include tenotomies of other tendons, particularly the anterior tibial tendon and incisions in the capsules of the talar joints.
马蹄内翻足是最常见的先天性骨科畸形之一，公元前400年希波克拉底就对其进行了描述。从古代的手法治疗到文艺复兴时期的夹板和石膏治疗，在跟腱切断术之前治疗方法已有改进。跟腱切断术在19世纪得到了验证，本文将对此进行阐述；跟腱皮下切断术的引入使外科医生将注意力集中在马蹄内翻足的手术治疗上。虽然该手术在矫正小儿麻痹症、脑瘫和陈旧性损伤所致的马蹄畸形方面非常成功，但它并非先天性马蹄内翻足患者的万灵药。要取得成功，必须在矫正马蹄畸形之前完全矫正前足内收和内翻，这样才能使患者受益。因此，手术范围扩大到包括其他肌腱的切断术，特别是胫骨前肌腱切断术以及距骨关节囊切开术。
