Associate Professor, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Assistant Professor, Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Foot Ankle Surg. 2020 Mar-Apr;59(2):418-422. doi: 10.1053/j.jfas.2019.08.018.
Treatment of persistent or recurrent equinus after repeated surgical releases can be challenging in patients with clubfoot. Anterior distal tibial epiphysiodesis has recently been used in patients with recurrent progressive equinus deformity, with inconsistent outcomes. Herein, we used this technique in a carefully selected subgroup (8 children, 9 feet) of patients with a severe equinus deformity and a flat-top talus. The patients were followed up with radiological and clinical measures for 12 to 18 months. The mean angle of the ankle improved significantly (25.5°, p < .0001). The mean anterior distal tibial angle decreased from 86.3° to 69° (p < .0001). Plantigrade foot was obtained in all patients, except 1 with arthrogryposis. When applied to carefully selected patients, anterior distal hemiepiphysiodesis of the tibia is an effective method for management of recurrent equinus deformity.
在有马蹄足的患者中，多次手术松解后仍持续或复发的马蹄足治疗具有挑战性。最近，在前胫骨远端骺板切除术已用于复发进行性马蹄足畸形患者中，但结果不一致。在此，我们将该技术用于一组（8 名儿童，9 足）严重马蹄足畸形和扁平足舟骨的患者中。对这些患者进行了 12 至 18 个月的影像学和临床随访。踝关节的平均角度明显改善（25.5°，p <.0001）。胫骨前远端角的平均角度从 86.3°减小到 69°（p <.0001）。除 1 例伴有关节挛缩的患者外，所有患者均获得了跖行足。当应用于仔细选择的患者时，胫骨前远端半骺板切除术是治疗复发性马蹄足畸形的有效方法。
