Hudson I, Catterall A
Royal National Orthopaedic Hospital, Stanmore and Charing Cross Hospital, London, England.
J Bone Joint Surg Br. 1994 Mar;76(2):281-4.
We treated 37 infants with 53 idiopathic club feet by posterolateral release alone at a mean age of 2.4 months. They were reviewed after a mean follow-up of 10 years 7 months. Both function and appearance were studied. Seventeen feet had required further surgery, at an average of four years after posterolateral release. In all cases hindfoot equinus had been well corrected; the mean ankle dorsiflexion at review was 15 degrees. Most feet showed subtalar joint movement of between 50% and 75% of normal. Four feet showed poor results: one had a stiff subtalar joint, two feet in one child showed fixed forefoot varus, and one foot had required a Dillwyn-Evans operation at 5.5 years. The overall reoperation rate of 32% at ten years suggests that a radical release operation is not necessary in all patients. Of 59 patients who had only a simple posterolateral release 27 (46%) have satisfactory results.
我们对37例患有53只特发性马蹄内翻足的婴儿仅采用后外侧松解术进行治疗，平均年龄为2.4个月。平均随访10年7个月后对他们进行了复查。对功能和外观都进行了研究。17只足需要进一步手术，平均在进行后外侧松解术4年后。所有病例中后足马蹄畸形均得到良好矫正；复查时平均踝关节背屈为15度。大多数足距下关节活动度为正常的50%至75%。4只足效果不佳：1只距下关节僵硬，1名儿童的2只足表现为固定性前足内翻，1只足在5.5岁时需要进行迪尔温 - 埃文斯手术。10年时32%的总体再次手术率表明并非所有患者都需要进行根治性松解手术。在仅进行简单后外侧松解术的59例患者中，27例（46%）效果满意。
