Hacen Mohamed Mahmoud El, Sghair Yacoub Mohamed, Biha Noura, Aw Abdoulay, Trigui Moez, Né Chekh
Orthopedic Department, Nouakchott Military Hospital, Faculty of Medicine of Nouakchott, Mauritania.
Pediatric Surgery, CHME-Nouakchott, Faculty of Medicine of Nouakchott, Mauritania.
Pan Afr Med J. 2018 Jul 20;30:222. doi: 10.11604/pamj.2018.30.222.15297. eCollection 2018.
Inveterate clubfoot (inveterate talipes equinovarus, ITEV) is a vicious attitude of the foot which doesn't rest on the floor through its normal base of support but weight is thrown to the outer side of the foot and to the foot point. When this vicious attitude persists a long time, it results in severe osteoarticular deformities in adults. Fixed ITEV is a good indication for tibiocalcaneal arthrodesis. In the majority of cases this provides painless and stable plantigrade foot. This study aims to assess the clinical and radiological outcomes of astragalectomy with tibiocalcaneal fusion. This case series involves 2 adult patients undergoing tibiocalcaneal arthrodesis due to severe and annoying equinovarus rearfoot deformity. Outcome was satisfactory with painless and stable plantigrade foot. At 90-day follow-up the patient with bilateral clubfoot had no inequality while the patient with unilateral clubfoot had a shortening of 2 cm compensated by right sole. In the majority of cases with severe and fixed deformities of the ankle and of the ITEV, tibiocalcaneal arthrodesis allows for painless and stable plantigrade foot, without vascular or cutaneous risk.
顽固性马蹄内翻足（顽固性马蹄足内翻，ITEV）是一种足部的不良姿态，足部并非通过其正常的支撑面着地，而是将体重转移至足的外侧及足尖。当这种不良姿态长期持续时，会导致成人出现严重的骨关节畸形。固定性ITEV是胫跟关节融合术的良好适应证。在大多数情况下，这能提供无痛且稳定的足底着地的足部状态。本研究旨在评估距骨切除术联合胫跟融合术的临床和影像学结果。该病例系列包括2例成年患者，因严重且令人困扰的马蹄足后足畸形而接受胫跟关节融合术。结果令人满意，足部无痛且稳定，足底着地。在90天的随访中，双侧马蹄内翻足患者无肢体不等长，而单侧马蹄内翻足患者有2厘米的短缩，由右足底代偿。在大多数踝关节及ITEV严重且固定畸形的病例中，胫跟关节融合术可实现无痛且稳定的足底着地的足部状态，无血管或皮肤风险。
