Ranjan Rahul, Sud Alok, Adhikary Debashis, Sinha Abhinav, Chand Suresh
All India Institute of Medical Sciences, Patna, Bihar.
Lady Hardinge Medical College, New Delhi.
J Pediatr Orthop B. 2019 Nov;28(6):572-578. doi: 10.1097/BPB.0000000000000595.
The incidence and risk factors of distal tibia/fibula fracture, an uncommon complication during Ponseti manipulation, are unknown. We evaluated 222 virgin clubfeet of patients aged less than 3 years for fractures of distal tibia/fibula. Incidence rate was found to be 1.3% per year. Associated risk factors were identified as neglected, syndromic clubfeet, feet requiring greater than 10 casts, post-tenotomy dorsiflexion less than 10° and casting by physician with less than 3 years of casting experience, with odds ratios of 14, 28, 4.9, 3.7 and 3.4, respectively. Most of these fractures healed without consequences; however, it is still advisable not to forcefully dorsiflex while casting, which may result in the fracture of distal tibia/fibula.
胫骨/腓骨远端骨折是庞塞蒂手法治疗过程中一种罕见的并发症，其发生率及危险因素尚不清楚。我们对222例3岁以下初诊马蹄内翻足患者的胫骨/腓骨远端骨折情况进行了评估。发现年发生率为1.3%。确定的相关危险因素包括马蹄内翻足未得到治疗、综合征性马蹄内翻足、需要超过10次石膏固定的足部、跟腱切断术后背屈小于10°以及由石膏固定经验少于3年的医生进行石膏固定，其优势比分别为14、28、4.9、3.7和3.4。这些骨折大多愈合良好，未产生不良后果；然而，在石膏固定时仍建议不要强行背屈，以免导致胫骨/腓骨远端骨折。
