Blauth W, von Törne O
Z Orthop Ihre Grenzgeb. 1978 Feb;116(1):1-6.
The authors discuss foot abnormalities in Apert's syndrome (acrocephalo-syndactyly). Characteristic of these deformities are bilateral, mostly symmetrical syndactlys of the toes; incorrect hyperextension positions of the first toe with large toes in flexed positions; intermetatarsal synostoeses, above all between the first and second metatarsal bones; multiple synostoses in the tarsal region; bi- and monophalanges with pseudo-, delta- or arcuate epiphyses. A classification of Apert's foot is presented, using 68 examples from the literature and 12 cases treated by the authors. The calssification is analogous to the hand deformities in Apert's syndrome. Three types can be distinguished: In type I, toes II-IV are webbed together. However, the large and small toes are still well separated. Syndactilys of toes II-V are present in type II, and all toes have grown together in type III. The deformity can be accompanied by stress pain and difficulties in providing shoes. In this case surgical correction is indicated in childhood: the incorrect position of the large toe is eliminated. Good results can be achieved via osteotomies of the metatarsal bones and resections of the intermetatarsal bone bridges.
作者们讨论了阿佩尔综合征(尖头并指畸形)中的足部异常情况。这些畸形的特征包括:双侧、大多对称的脚趾并指;大脚趾处于屈曲位时第一趾的不正确背伸姿势;跖骨间融合,尤其是第一和第二跖骨之间;跗骨区域的多处融合;具有假骨骺、三角形骨骺或弓形骨骺的双指节和单指节。利用文献中的68个实例以及作者治疗的12个病例,提出了阿佩尔足部畸形的一种分类方法。该分类与阿佩尔综合征中的手部畸形类似。可分为三种类型:在I型中,第二至四趾蹼连在一起。然而,大脚趾和小脚趾仍分得很开。II型存在第二至五趾并指,III型中所有脚趾都连在了一起。这种畸形可能伴有应力性疼痛以及穿鞋困难。在这种情况下,儿童期需进行手术矫正:消除大脚趾的不正确位置。通过跖骨截骨术和切除跖骨间骨桥可取得良好效果。