Dutoit M, Rigault P, Padovani J P, Pouliquen J C, Finidori G, Touzet P, Guyonvarch G
Rev Chir Orthop Reparatrice Appar Mot. 1984;70(3):231-43.
The authors have studied 32 tarsal coalitions in 20 children. Twenty two were between the talus and the calcaneum, 4 were medial and 6 were rare varieties. The diagnosis is often missed because 40 p. 100 of the children with tarsal coalition had no complaints. The indirect radiological signs have been analysed and precise techniques described for detecting the coalition. Only 11 feet were operated on. On 4 occasions the coalition was simply resected. This always gave a good functional result and good mobility was obtained in the subtaloid joint in 2 cases. The other cases were treated by triple arthrodesis. The authors consider that an earlier diagnosis would lead to better prevention of secondary deformities. The best indication for simple resection is in coalition between the calcaneum and the navicular.
作者研究了20名儿童的32例跗骨联合。其中22例发生在距骨和跟骨之间,4例为内侧型,6例为罕见类型。由于40%的跗骨联合患儿没有症状,所以诊断常常被漏诊。分析了间接放射学征象,并描述了用于检测联合的精确技术。仅11只足接受了手术。4例仅行联合切除术。这总能带来良好的功能结果,2例距下关节获得了良好的活动度。其他病例采用三关节融合术治疗。作者认为早期诊断将更好地预防继发畸形。单纯切除术的最佳适应证是跟骨与舟骨之间的联合。