Farsetti P, Weinstein S L, Ponseti I V
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242-1088.
J Bone Joint Surg Am. 1994 Feb;76(2):257-65. doi: 10.2106/00004623-199402000-00014.
Thirty-one patients (forty-five feet) who had metatarsus adductus were evaluated at our institution and were followed for an average of thirty-two years and six months. Of these thirty-one patients, twenty-one (thirty-one feet) were examined clinically and radiographically. Information on the remaining ten patients (fourteen feet) was obtained by letter or telephone, or both. Twelve patients (sixteen feet) who had a passively correctable deformity (mild or moderate) at the time of the initial presentation had no treatment. Twenty patients (twenty-nine feet) who had a partly flexible or rigid deformity (moderate or severe) at the time of the initial presentation were managed with serial manipulation and application of plaster holding casts. (One patient who had a bilateral deformity had no treatment on one side and conservative management on the other). The results were good in all sixteen of the untreated feet and in twenty-six (90 per cent) of the twenty-nine feet that had been conservatively treated. There were no poor results. The passively correctable deformities resolved spontaneously. Radiographs showed an obliquity of the medial cuneiform-metatarsal joint in twenty-one (68 per cent) of the thirty-one feet that were examined clinically and radiographically. Similar findings were observed in four of eleven contralateral, normal feet. Hallux valgus was not a common outcome. No patient had operative correction.
31例患有内收型足的患者（45足）在我们机构接受了评估，并平均随访了32年6个月。在这31例患者中，21例（31足）接受了临床和影像学检查。其余10例患者（14足）的信息通过信件或电话或两者获取。12例患者（16足）在初次就诊时具有可被动矫正的畸形（轻度或中度），未接受治疗。20例患者（29足）在初次就诊时具有部分柔韧性或僵硬性畸形（中度或重度），接受了连续手法治疗并应用了石膏固定支具。（1例双侧畸形患者一侧未治疗，另一侧接受了保守治疗）。所有16例未治疗的足以及29例接受保守治疗的足中的26例（90%）结果良好。没有不良结果。可被动矫正的畸形自行缓解。在接受临床和影像学检查的31足中的21足（68%）中，X线片显示内侧楔骨-跖骨关节倾斜。在11例对侧正常足中的4例中也观察到了类似的发现。拇外翻并不常见。没有患者接受手术矫正。
