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创伤后“精神性马蹄内翻足”(作者译)

[The posttraumatic "psychogenic club-foot" (author's transl)].

作者信息

Katthagen B D, Scheuer I

出版信息

Arch Orthop Trauma Surg (1978). 1980;97(3):193-5. doi: 10.1007/BF00389726.

Abstract

Two cases of posttraumatic "psychogenic clubfoot" deformity are reported. Case I. A woman, aged 44, with foot deformity after infantile paralysis on the right side sustained an inversion injury to the left ankle in April 1979. Two weeks later she was admitted to our hospital. She was unable to walk and examination showed a drop foot with supination contracture of the left foot. Neurological examination was normal inclusive electromyogram. Ligaments of the ankle and peroneal tendons were reviewed by operative procedure under suspicion of rupture. There were no pathological findings, no hematomas or other traumatic signs. The neurological control examination was normal and psychogenic contracture was diagnosed. The personal history showed a corresponding problematical psychic background. Case II. A man, aged 24, was admitted to our hospital 3 months after an inversion injury to the right ankle. Examination showed a drop foot with supination contracture (Fig. 1 a, b). He walked with two crutches. Roentgenograms were normal, the ankle had normal stability, and neurological examination showed no pathological findings. There were no signs of an organic lesion. Psychogenic club-foot was diagnosed. Both patients were treated functionally with active exercises and psychological care. The follow-up control 1 resp. 1/2 year after injury showed normal muscles and free active mobility in both cases (Fig. 1 c, d).

摘要

报告了2例创伤后“精神性马蹄内翻足”畸形病例。病例一:一名44岁女性,右侧婴儿瘫后遗留足部畸形,1979年4月左侧踝关节遭受内翻损伤。两周后入院。她无法行走,检查发现左足下垂伴内旋挛缩。神经学检查包括肌电图均正常。因怀疑韧带断裂及腓骨肌腱损伤,对踝关节韧带进行了手术探查。未发现病理改变,无血肿或其他创伤迹象。神经学对照检查正常,诊断为精神性挛缩。个人史显示有相应的可疑精神背景。病例二:一名24岁男性,右侧踝关节内翻损伤3个月后入院。检查发现足下垂伴内旋挛缩(图1 a、b)。他借助双拐行走。X线片正常,踝关节稳定性正常,神经学检查未发现病理改变。无器质性病变迹象。诊断为精神性马蹄内翻足。两名患者均接受了功能锻炼及心理护理治疗。伤后1年及半年的随访对照显示,两例患者肌肉均正常,活动自如(图1 c、d)。

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