Lefort G, Sleiman M, Lefebvre F, Daoud S
Service de Chirurgie Infantile, American Memorial Hospital, C.H.U. Reims.
Rev Chir Orthop Reparatrice Appar Mot. 1994;80(3):246-51.
This study is a critical analysis of the results in a homogeneous series of 260 cases of congenital clubfoot followed from birth.
This series of congenital club feet was divided in 2 groups: the stiff forms (144 cases) and the supple forms (116 cases). Daily physical therapy and Denis Brown's splints were begun from the first examination. This method did not allow full correction of deformations in 213 cases. A posterior medial surgical release was performed. Its importance depended on the criteria of radio-clinical analysis before surgery. 46 feet were operated twice.
Follow up averaged 7 years. 39 per cent of patients had completed growth, only 18 per cent of feet were not operated. With the surgical treatment, the results were ""very good'' and ""good'' in 75.1 per cent of cases, according to an analysis using Seringe's criteria. 21 per cent were operated again, on an average between 3 and 8 years, with poorer results than at first surgery.
The quality of the results depends on the quality of the functional treatment. Poor control of equinism with Denis-Brown splints can be corrected by using Seringe's articulated splints or by a series of plaster casts.
Many technical factors influence the results. The quality of post-operative contention is stressed.
本研究对260例从出生起就开始跟踪的先天性马蹄内翻足同类病例的结果进行了批判性分析。
这一系列先天性马蹄内翻足分为两组：僵硬型（144例）和柔软型（116例）。从首次检查开始即进行每日物理治疗并使用丹尼斯·布朗夹板。该方法在213例病例中未能完全矫正畸形。进行了后内侧手术松解。其重要性取决于手术前放射学临床分析的标准。46只脚接受了二次手术。
随访平均7年。39%的患者已完成生长发育，仅18%的足部未接受手术。根据使用塞林格标准进行的分析，手术治疗后，75.1%的病例结果为“非常好”和“好”。21%的患者在平均3至8年后再次接受手术，结果比首次手术差。
结果的质量取决于功能治疗的质量。使用丹尼斯·布朗夹板对马蹄足内翻控制不佳的情况可通过使用塞林格关节夹板或一系列石膏 casts 来纠正。
许多技术因素影响结果。强调了术后护理的质量。 （注：这里原文“casts”后似乎少了一些内容，暂按此翻译）
