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评估新生儿特发性马蹄内翻足的早期跟腱切断术。

Assessment of early Achilles tenotomy in the newborn idiopathic pes equinovarus.

出版信息

Acta Orthop Belg. 2022 Jun;88(2):231-236. doi: 10.52628/88.2.8547.

Abstract

We aimed to evaluate the clinical and radiological results of early Achilles tenotomy which was performed before Ponseti method in PEV deformities. 37 feet of 26 patients with Dimeglio type 3 and 4 deformities were included in the study. Unlike the classical Ponseti method, patients underwent a mini-open Achilles tenotomy before the first cast. 6-month follow-up of the foot deformities were assessed using Dimeglio classification clinically and lateral talocalcaneal and tibiocalcaneal angles radiologically. There were 20 male and 6 female patients with the median age of 14 days (4-37 days) and 11 bilateral and 15 unilateral deformities. The average follow-up period was 7 months (6-12 months). The mean Dimeglio scores before the Achilles tenotomy and Dimeglio score at the 6 th month follow-up were 14 (11-16) and 4 (4-6) for the right feet, 13 (10-16) and 4 (4-6) for the left feet respectively. The mean number of casting was 3.8 ± 0.4 for right feet and 3.7 ± 0.4 for left feet. The mean talocalcaneal angle was 24 ± 8.2 degrees for the right feet and 27 ± 8.2 degrees for the left feet. The mean tibiocalcaneal angle was 69 ± 12 for the right feet and 72 ± 14 degrees for the left feet. Early Achilles tenotomy can decrease the total number of cast for deformity correction in Ponseti method and provide good clinical and radiological outcomes at 6 th month follow-up in severe PEV deformities according to Dimeglio classification.

摘要

我们旨在评估在 Ponseti 方法之前对 PEV 畸形进行早期跟腱切断术的临床和影像学结果。研究纳入了 26 名患者的 37 只脚,其中 Dimeglio 3 型和 4 型畸形 15 只,Dimeglio 5 型和 6 型畸形 22 只。与经典的 Ponseti 方法不同,患者在第一次石膏固定前接受微创跟腱切断术。通过 Dimeglio 分类,对足部畸形进行临床评估,并对侧跟距角和跟骨距骨角进行影像学评估,随访 6 个月。患者包括 20 名男性和 6 名女性,中位年龄为 14 天(4-37 天),11 例双侧,15 例单侧畸形。平均随访时间为 7 个月(6-12 个月)。右侧跟腱切断术前 Dimeglio 评分和 6 个月随访时 Dimeglio 评分分别为 14(11-16)和 4(4-6),左侧分别为 13(10-16)和 4(4-6)。右侧石膏固定次数为 3.8±0.4 次,左侧为 3.7±0.4 次。右侧跟距角为 24±8.2°,左侧为 27±8.2°。右侧跟骨距骨角为 69±12°,左侧为 72±14°。早期跟腱切断术可以减少 Ponseti 方法矫正畸形的石膏固定次数,根据 Dimeglio 分类,在严重 PEV 畸形中,6 个月随访时可获得良好的临床和影像学结果。

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