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儿童后天性平足症（病例报告）

Acquired Flat-foot in a Child (Report of a Case).

作者信息

Shahcheraghil Gholam Hossain, Javid Mahzad, Chabok Seyyed Kazem

机构信息

Department of Orthopaedic, Bone and Joint Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Orthopaedic, Ordibehesht Hospital, Shiraz, Iran.

出版信息

J Orthop Case Rep. 2018 Jan-Feb;8(1):64-66. doi: 10.13107/jocr.2250-0685.1002.

DOI:10.13107/jocr.2250-0685.1002
PMID:29854697
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5974681/
Abstract

INTRODUCTION

Unilateral secondary flat-foot in children is unusual, and in the absence of a major trauma history should raise suspicion of a neuromuscular etiology. Flatfoot from tibialis posterior tendon (TPT) rupture in children is very rare.

CASE REPORT

A 10-year-old girl presented with unilateral flatfoot and unusual shoe wear of few years duration. A TPT rupture was diagnosed. After observing a 3-4 mm superficial scar behind medial malleolus, and after a lot of questioning, her mother remembered an abrasion she had sustained 6 years ago playing in a park.She was successfully treated by flexor hallucis longus (FHL) tendon transfer and obtained and maintained a nice longitudinal arch.

CONCLUSION

TPT rupture in children may happen by a minor laceration or trauma and be only recognized after developing flatfoot. FHL tendon transfer can restore the arch even in late cases.

摘要

引言

儿童单侧继发性扁平足并不常见，在没有重大创伤史的情况下，应怀疑存在神经肌肉病因。儿童胫后肌腱（TPT）断裂导致的扁平足非常罕见。

病例报告

一名10岁女孩出现单侧扁平足及持续数年的异常鞋磨损情况。诊断为TPT断裂。在内踝后方观察到一条3 - 4毫米的浅表瘢痕，经过大量询问后，她的母亲记起6年前她在公园玩耍时受过一次擦伤。她通过拇长屈肌（FHL）肌腱转移术成功治愈，获得并维持了良好的纵弓。

结论

儿童TPT断裂可能由轻微撕裂伤或创伤引起，且仅在出现扁平足后才被发现。即使在晚期病例中，FHL肌腱转移也能恢复足弓。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/d1e143c87328/JOCR-8-64-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/11f1fc21d59b/JOCR-8-64-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/19a25fee5804/JOCR-8-64-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/e6df7246a989/JOCR-8-64-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/714321062dae/JOCR-8-64-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/d1e143c87328/JOCR-8-64-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/11f1fc21d59b/JOCR-8-64-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/19a25fee5804/JOCR-8-64-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/e6df7246a989/JOCR-8-64-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/714321062dae/JOCR-8-64-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/867b/5974681/d1e143c87328/JOCR-8-64-g005.jpg

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本文引用的文献

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Tibialis posterior tendon rupture associated with a closed medial malleolar fracture: a case report and review of the literature.闭合性内踝骨折伴胫后肌腱断裂：1例病例报告及文献复习
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Rupture of the tibialis posterior tendon: an important differential in the assessment of ankle injuries.胫后肌腱断裂：踝关节损伤评估中的一个重要鉴别点。
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The effect of posterior tibialis tendon dysfunction on the plantar pressure characteristics and the kinematics of the arch and the hindfoot.
胫后肌腱功能障碍对足底压力特征以及足弓和后足运动学的影响。
Clin Biomech (Bristol). 2004 Feb;19(2):161-9. doi: 10.1016/j.clinbiomech.2003.10.007.
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Tibialis posterior tendon rupture in children.儿童胫后肌腱断裂
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Pes planus in childhood due to tibialis posterior tendon injuries. Treatment by flexor hallucis longus tendon transfer.儿童因胫后肌腱损伤导致扁平足。采用拇长屈肌腱转移术治疗。
J Bone Joint Surg Br. 1994 May;76(3):444-6.
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Injury of the tibialis posterior tendon: a cause of acquired valgus foot in childhood.胫后肌腱损伤：儿童后天性外翻足的一个病因。
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Rupture of the posterior tibial tendon causing flat foot. Surgical treatment.胫后肌腱断裂导致扁平足。手术治疗。
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