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先天性马蹄内翻足的管理与结局:沙特阿拉伯阿卜哈儿科三级中心的经验

Congenital Talipes Equinovarus Management and Outcomes: The Experiences of Pediatric Tertiary Centers in Abha, Saudi Arabia.

作者信息

Kardm Saleh M, Al Zomia Ahmed S, Alqahtani Ali A, Al Fae Faisal M, Al Zehefa Ibrahim A, Alshahrani Yazeed S, A AlShehri Fahad A, Alqarni Abdulrhman M, Alqahtani Abdulrahman S

机构信息

Department of Orthopedics, Faculty of Medicine, Najran University, Najran, SAU.

College of Medicine, King Khalid University, Abha, SAU.

出版信息

Cureus. 2023 Aug 10;15(8):e43264. doi: 10.7759/cureus.43264. eCollection 2023 Aug.

Abstract

BACKGROUND

Congenital talipes equinovarus (CTEV), also known as clubfoot, describes a range of foot abnormalities usually present at birth (congenital) in which a baby's foot is twisted out of shape or position. In clubfoot, tendons are shorter than usual. Clubfoot is a fairly common birth defect and is usually an isolated problem for an otherwise healthy newborn.

AIM

This study aimed to investigate the experiences of pediatric tertiary centers in Abha, Saudi Arabia, regarding the management, frequency, treatment options, and outcomes of CTEV.

METHODS

A retrospective chart review of pediatric patients with clubfoot was conducted to evaluate the number of cases, treatment options, and outcomes at Abha Maternity and Children Hospital and Khamis Mushait Maternity and Children Hospital. Data were extracted independently using prestructured data extraction forms. The collected data included demographic and medical information, family history, clinico-epidemiological information, risk factors, management options, and complications of clubfoot.

RESULTS

The study included 89 children with CTEV from the target hospitals. Their ages ranged from 20 days to six years, with a mean age of 10.5 ± 14.5 months. Of these, 57 (64%) were male. CTEV was unilateral in 53 (59.5%) cases and bilateral in 36 (40.5%) cases. The majority of the cases had isolated CTEV. Nearly all cases had Ponseti casting with a tendo-Achilles tenotomy (TAT) surgical procedure. Patient follow-up ranged from one week to three years, with an average follow-up of 3.1 months. Only three (3.4%) cases experienced recurrence of deformity after management.

CONCLUSION

Ponseti casting with the tendo-Achilles tenotomy approach emerged as the most commonly employed management option, demonstrating a low rate of recurrence.

摘要

背景

先天性马蹄内翻足(CTEV),又称马蹄足,描述了一系列通常在出生时(先天性)就存在的足部异常情况,即婴儿的脚扭曲变形或位置异常。在马蹄足中,肌腱比正常情况短。马蹄足是一种相当常见的出生缺陷,对于其他方面健康的新生儿来说,通常是一个孤立的问题。

目的

本研究旨在调查沙特阿拉伯阿卜哈市儿科三级中心在先天性马蹄内翻足的管理、发病率、治疗选择和治疗结果方面的情况。

方法

对患有马蹄足的儿科患者进行回顾性病历审查,以评估阿卜哈妇产儿童医院和哈米斯穆谢特妇产儿童医院的病例数量、治疗选择和治疗结果。使用预先构建的数据提取表独立提取数据。收集的数据包括人口统计学和医学信息、家族史、临床流行病学信息、危险因素、管理选择以及马蹄足的并发症。

结果

该研究纳入了来自目标医院的89例先天性马蹄内翻足患儿。他们的年龄从20天到6岁不等,平均年龄为10.5±14.5个月。其中,57例(64%)为男性。先天性马蹄内翻足单侧发病53例(59.5%),双侧发病36例(40.5%)。大多数病例为孤立性先天性马蹄内翻足。几乎所有病例都采用了庞塞蒂石膏固定加跟腱切断术(TAT)的手术方法。患者随访时间从1周到3年不等,平均随访时间为3.1个月。管理后只有3例(3.4%)出现畸形复发。

结论

庞塞蒂石膏固定加跟腱切断术是最常用的管理方法,复发率较低。

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本文引用的文献

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Congenital talipes equinovarus: A literature review.先天性马蹄内翻足:文献综述
Ann Med Surg (Lond). 2022 Aug 18;81:104394. doi: 10.1016/j.amsu.2022.104394. eCollection 2022 Sep.
6
Genetics of clubfoot; recent progress and future perspectives.马蹄内翻足的遗传学:近期进展与未来展望
Eur J Med Genet. 2018 Feb;61(2):107-113. doi: 10.1016/j.ejmg.2017.09.006. Epub 2017 Sep 14.
10
Genetics of clubfoot.马蹄内翻足的遗传学
J Pediatr Orthop B. 2012 Jan;21(1):7-9. doi: 10.1097/BPB.0b013e328349927c.

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