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综述文章:先天性马蹄内翻足治疗的当前概念

Review Article: Current Concepts in the Treatment of Congenital Clubfoot.

作者信息

Nogueira Francisco, Poggiali Pedro

机构信息

Rede Mater Dei de Saúde, Belo Horizonte, MG, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Dec 21;59(6):e821-e829. doi: 10.1055/s-0044-1787769. eCollection 2024 Dec.

Abstract

Congenital clubfoot is a complex, frequent deformity that can be challenging even in experienced hands. The Ponseti method remains universally accepted as the gold standard for treatment, and excellent outcomes are within expectations in most cases with appropriate technical management. Recurrences continue to be a problem and are mainly associated with non-compliance with orthosis use. However, other factors may influence the risk of recurrence and contribute to an unsatisfactory outcome. Tibialis anterior transfer balances deforming forces and helps correction as long as the foot is flexible. A recurred deformity is not corrected spontaneously, it requires treatment. Adjuvant surgical procedures should be part of the orthopedist's therapeutic arsenal.

摘要

先天性马蹄内翻足是一种复杂且常见的畸形,即使是经验丰富的医生处理起来也颇具挑战性。庞塞蒂方法仍是普遍公认的治疗金标准,在大多数情况下,通过适当的技术管理,有望获得良好的治疗效果。复发仍是一个问题,主要与未坚持使用矫形器有关。然而,其他因素可能会影响复发风险,并导致治疗效果不理想。只要足部具有柔韧性,胫前肌移位可平衡致畸形力并有助于矫正。复发的畸形不会自行矫正,需要进行治疗。辅助手术应成为骨科医生治疗手段的一部分。

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