Södergård J, Ryöppy S
Department of Surgery and Orthopedics, Children's Hospital, University Central Hospital, Helsinki, Finland.
J Pediatr Orthop. 1994 Nov-Dec;14(6):768-72. doi: 10.1097/01241398-199414060-00015.
Foot deformities are common in arthrogryposis multiplex congenita. In this group of 52 patients with this diagnosis, 43 had foot deformities. The involvement was bilateral in all cases, and the most common type of deformity was talipes equinovarus (72 feet). The primary treatment in 52 of these patients was operative. Brockmann's procedure was the preferred method during the earlier years and posteromedial or posteromedioplantar release since 1974. Recurrences of the deformity are common; 36 operative procedures were done in 15 feet for recurrence of talipes equinovarus. The primary operative treatment should be extensive enough to correct all components of the deformity. Knee and hip deformity will often influence the outcome. Knee deformities especially cause problems in retaining the desired position of the feet. Talectomy and bone decancellations both seem to be effective in treating recurrences.
足部畸形在先天性多发性关节挛缩症中很常见。在这组52例诊断为此病的患者中，43例有足部畸形。所有病例均为双侧受累，最常见的畸形类型是马蹄内翻足（72只脚）。其中52例患者的主要治疗方法是手术。在早期，布罗克曼手术是首选方法，自1974年以来则采用后内侧或后内侧足底松解术。畸形复发很常见；15只脚因马蹄内翻足复发进行了36次手术。初次手术治疗应足够广泛，以纠正畸形的所有组成部分。膝关节和髋关节畸形常常会影响治疗结果。膝关节畸形尤其会在维持足部理想位置方面造成问题。距骨切除术和骨松质切除术在治疗复发方面似乎都有效。
