From the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO (Dr. Johnson, Dr. Klein, Dr. McCormick, Dr. Dobbs, Dr. Gordon, Dr. Schoenecker); the Department of Orthopaedic Surgery, Dartmouth-Hitchcock School of Medicine, New Hampshire, NH (Dr. Fortney); and the Congress Orthopaedic Associates, Arcadia, CA (Dr. Luk).
J Am Acad Orthop Surg Glob Res Rev. 2020 May;4(5):e1900126. doi: 10.5435/JAAOSGlobal-D-19-00126.
Children with congenital clubfoot often have residual deformity, pain, and limited function in adolescence and young adulthood. These patients represent a heterogeneous group that often requires an individualized management strategy. This article reviews the available literature on this topic while proposing a descriptive classification system based on a review of patients at our institution who underwent surgery for problems related to previous clubfoot deformity during the period between January 1999 and January 2012. Seventy-two patients (93 feet) underwent surgical treatment for the late effects of clubfoot deformity at an average age of 13 years (range 9 to 19 years). All patients had been treated at a young age with serial casting, and most had at least one previous surgery on the affected foot or feet. Five common patterns of pathology identified were as follows: undercorrection, overcorrection, dorsal bunion, anterior ankle impingement, and lateral hindfoot impingement. Management pathways for each group of the presenting problems is described. To our knowledge, this topic review represents the largest report of adolescent and young adult patients with residual clubfoot deformity in the literature.
先天性马蹄内翻足患儿在青少年和青年期常遗留畸形、疼痛和功能受限。这些患者属于异质性群体，通常需要个体化的管理策略。本文回顾了这一主题的现有文献，并基于对我院 1999 年 1 月至 2012 年 1 月期间因既往马蹄内翻足畸形相关问题接受手术治疗的患者进行回顾，提出了一个描述性分类系统。72 例（93 足）患者在平均 13 岁（9~19 岁）时因马蹄内翻足畸形的晚期效应接受了手术治疗。所有患者均在幼年时接受过系列石膏固定，大多数患者至少接受过一次受累足的手术治疗。确定了 5 种常见的病理类型：矫形不足、矫形过度、背侧足母囊炎、前踝撞击和外踝撞击。描述了每组表现问题的处理方法。据我们所知，这一主题综述代表了文献中最大的一组遗留马蹄内翻足畸形的青少年和青年患者的报道。
