Dodge L D, Ashley R K, Gilbert R J
Foot Ankle. 1987 Jun;7(6):326-32. doi: 10.1177/107110078700700602.
To ascertain whether one type of treatment of the congenital vertical talus was superior to others, we conducted a retrospective analysis of 36 congenital vertical tali in 21 patients whose average follow-up of 14 years was considered to be unusually lengthy. Ten patients (48%) had an underlying primary diagnosis, and 13 patients (62%) had at least one other secondary congenital abnormality. None of the surgical techniques produced significantly better results than any other one according to criteria involving shoewear, range of motion, and degree of pain. Subtalar and talotibial motion were frequently restricted, with or without prior arthrodesis. Pain generally was not an immediate or long-term problem. To maintain maximal foot mobility, we recommend a one-stage soft tissue correction alone in the child under 3 years of age. In older, untreated children or those in whom conservative treatments have failed, a subtalar or triple arthrodesis may be necessary.
为确定先天性垂直距骨的一种治疗方法是否优于其他方法，我们对21例患者的36例先天性垂直距骨进行了回顾性分析，这些患者平均随访14年，这一随访时间被认为异常之长。10例患者（48%）有潜在的原发性诊断，13例患者（62%）至少有一项其他继发性先天性异常。根据鞋类、活动范围和疼痛程度等标准，没有一种手术技术产生的结果明显优于其他技术。距下关节和胫距关节活动常常受限，无论是否有既往关节融合术。疼痛通常不是即刻或长期问题。为保持足部最大程度的活动度，我们建议对3岁以下儿童仅进行一期软组织矫正。对于年龄较大、未经治疗的儿童或保守治疗失败的儿童，可能需要进行距下关节或三关节融合术。
