Hjelmstedt A, Sahlstedt B
Acta Orthop Scand. 1980 Apr;51(2):335-47. doi: 10.3109/17453678008990807.
By simultaneous arthrography of the talocrural and talonavicular joints it is possible to demonstrate and measure the most important skeletal deformities in clubfoot. In this way it has been possible to establish the indications for alternative forms of treatment with a greater degree of precision. Most of our refractory or recurrent clubfeet have been treated successfully by various soft tissue procedures. In cases with severe talar deformity, however, these procedures have been complemented by correction osteotomy through the talar neck and calcaneus. The aim is to create muscle balance by soft tissue procedures and to correct pronounced skeletal deformities by osteotomy. This treatment plan has been used in about 50 of our clubfoot cases. The principles, objectives and indications of the surgical therapy are discussed in this article. The operative technique, as it has been developed with increasing experience, is described, and if careful attention is paid to all details the risk of complications is small and the correction is generally satisfactory. It must be emphasized that correction osteotomy is only a part of an overall treatment plan and that this operation is only indicated in a minority of clubfoot cases.
通过同时对距小腿关节和距舟关节进行关节造影，可以显示和测量马蹄内翻足最重要的骨骼畸形。通过这种方式，能够更精确地确定替代治疗方法的适应症。我们大多数难治性或复发性马蹄内翻足已通过各种软组织手术成功治疗。然而，在距骨严重畸形的病例中，这些手术通过经距骨颈和跟骨的矫正截骨术得到补充。目的是通过软组织手术实现肌肉平衡，并通过截骨术矫正明显的骨骼畸形。该治疗方案已应用于我们大约50例马蹄内翻足病例。本文讨论了手术治疗的原则、目标和适应症。描述了随着经验增加而发展起来的手术技术，如果仔细关注所有细节，并发症风险很小，矫正效果通常令人满意。必须强调的是，矫正截骨术只是整体治疗方案的一部分，并且这种手术仅适用于少数马蹄内翻足病例。
