Hjelmstedt A, Sahlstedt B
Acta Orthop Scand. 1980 Apr;51(2):349-57. doi: 10.3109/17453678008990808.
Thirty-six refractory or recurrent clubfeet were treated by correction osteotomy through the talar neck and calcaneus in combination with various soft tissue procedures. The aim of the osteotomies was to correct the pronounced deformities observed at simultaneous arthrography of the talocrural and talonavicular joints. The soft tissue procedures were carried out to facilitate the correction and to prevent recurrence by creating muscle balance. Twenty-four clubfeet were idiopathic and 12 were secondary to neurological or other diseases. The observation period since the osteotomies were performed was, at the time of writing, 1.5 to 5.5 years (median 3 years). A brief report of the indications and methods of operation is given. Good or fair results were achieved in 21 of the 24 idiopathic clubfeet, while the results were somewhat poorer in the secondary clubfeet. A correlation between the degree of arthrographically demonstrated talar deformity and the results of surgical treatment was found. The main reason for a poor result was incomplete correction of the most extreme talar deformity in combination with marked preoperative joint rigidity.
三十六例难治性或复发性马蹄内翻足采用经距骨颈和跟骨截骨矫正术并结合多种软组织手术进行治疗。截骨术的目的是纠正距小腿关节和距舟关节同时造影时所观察到的明显畸形。进行软组织手术是为了促进矫正并通过建立肌肉平衡来防止复发。二十四例马蹄内翻足为特发性，十二例继发于神经或其他疾病。在撰写本文时，自截骨术实施后的观察期为1.5至5.5年（中位值3年）。给出了手术适应证和方法的简要报告。24例特发性马蹄内翻足中有21例取得了良好或尚可的结果，而继发性马蹄内翻足的结果稍差。发现造影显示的距骨畸形程度与手术治疗结果之间存在相关性。结果不佳的主要原因是最严重的距骨畸形矫正不完全并伴有术前明显的关节僵硬。
