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Charcot-Marie-Tooth 病足部畸形的手术治疗前瞻性研究。

A prospective study on surgical management of foot deformities in Charcot Marie tooth disease.

机构信息

Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK.

Foot and ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.

出版信息

J Peripher Nerv Syst. 2021 Jun;26(2):187-192. doi: 10.1111/jns.12437. Epub 2021 Mar 13.

Abstract

Foot deformities are frequently observed in patients with Charcot Marie tooth disease (CMT) and orthopaedic surgery is often required. Currently there is no evidence-based guideline on surgical management and only a few studies which have evaluated long-term outcomes of surgical procedures. The aim of the study was to evaluate longitudinally the effect of foot surgery in a cohort of CMT patients. Twenty-five CMT adult patients were assessed using a comprehensive group of validated scales and questionnaires before and after surgery. A wide range of surgical procedures was performed by one team of dedicated foot ankle orthopaedic surgeons. Foot alignment as measured by the foot posture index, pain, quality of life and callosities significantly improved after one year and the improvement was maintained up to 4 years after surgery. There was a trend towards a reduction in the number of falls post-operatively. Surgery had no effect on fatigue, balance and CMT examination score. Our findings showed significant improvement of pain, foot alignment, callosities and quality of life after surgery and suggested that foot deformity correction in adults with CMT performed in a specialised foot and ankle unit is beneficial.

摘要

足畸形在遗传性运动感觉神经病(CMT)患者中很常见,通常需要进行矫形手术。目前,针对手术治疗管理还没有基于循证医学的指南,仅有少数研究评估了手术治疗的长期效果。本研究的目的是通过对一组 CMT 患者进行纵向评估,来评估足部手术的效果。25 例 CMT 成年患者在手术前后使用一系列经过验证的综合量表和问卷进行评估。由一支专注于足踝矫形外科的团队为这些患者实施了广泛的手术。术后一年,足部姿势指数、疼痛、生活质量和胼胝的测量结果显示足部对线明显改善,术后 4 年仍保持这种改善。术后跌倒的次数有减少的趋势。手术对疲劳、平衡和 CMT 检查评分没有影响。我们的研究结果表明,手术后疼痛、足部对线、胼胝和生活质量都有显著改善,提示在专门的足踝外科治疗 CMT 成人足畸形是有益的。

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