Otremski I, Salama R, Khermosh O, Wientroub S
Department of Orthopaedic Surgery, Tel-Aviv Medical Centre, Israel.
J Bone Joint Surg Br. 1987 Nov;69(5):832-4. doi: 10.1302/0301-620X.69B5.3680353.
Forty-four feet in 28 children previously treated by a one-stage posteromedial release operation (the Turco procedure) were reviewed clinically and radiologically to determine the cause of residual adduction of the forefoot. In 21 clinically adducted feet (48%) the main cause of residual deformity was metatarsus varus alone or metatarsus varus in spite of talonavicular overcorrection; in five feet the cause was talonavicular subluxation. There was no residual adduction in 23 feet (52%) but only 12 had normal radiographic measurements. In the remaining feet, various forms of spurious correction of metatarsus varus and talonavicular subluxation or both were seen, resulting in normal-looking feet. Recession of the origin of abductor hallucis and release of the short plantar muscles and fascia at the time of posteromedial release is recommended. The forefoot adduction was satisfactorily corrected in 91% of the feet subsequently operated on using this modified procedure.
对28名曾接受一期后内侧松解手术（Turco手术）治疗的儿童的44只脚进行了临床和放射学检查，以确定前足残留内收的原因。在21只临床内收的脚（48%）中，残留畸形的主要原因是单纯的跖骨内翻或尽管距舟关节过度矫正但仍存在跖骨内翻；在5只脚中，原因是距舟关节半脱位。23只脚（52%）没有残留内收，但只有12只脚的放射学测量正常。在其余的脚中，可见各种形式的跖骨内翻和距舟关节半脱位或两者的假性矫正，导致外观正常的脚。建议在进行后内侧松解时，将拇展肌起点后移，并松解足底短肌和筋膜。采用这种改良手术，随后接受手术的脚中有91%的前足内收得到了满意的矫正。
