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先天性马蹄内翻足非手术治疗成功后的临床及影像学表现

Clinical and radiographic appearance of congenital talipes equinovarus after successful nonoperative treatment.

作者信息

Napiontek M

机构信息

Department of Pediatric Orthopaedics, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.

出版信息

J Pediatr Orthop. 1996 Jan-Feb;16(1):67-72. doi: 10.1097/00004694-199601000-00014.

Abstract

Thirty-one children with 49 feet after successful nonoperative treatment for congenital talipes equinovarus (CTEV) by redressements, hypoallergic adhesive bands, and plaster casts underwent follow-up. At the follow-up, the patients ranged in age from 4.2 years to 12.3 years (average, 8.3 years). The initial type of the deformity was as follows: type I (mild), 18 feet; type II (intermediate), 29 feet; type III (severe), two feet. Mild supination of the forefoot in five feet, isolated excavation in three, and adduction greater than physiological in two feet were the only persistent elements of the deformity. The lack or restriction of the dorsal flexion in the ankle were noted in 22 feet. In only three feet was the Beatson-Pearson index was < 40 degrees. In 17 feet, the radiographs revealed full talonavicular reduction in sagittal and horizontal planes. The average value of the talometatarsal first and tibiocalcaneal angles as in accordance with the standard. The most characteristic osseous disturbances concerned the tarsal navicular (22 feet) and consisted of the decrease of the ossification center, its flattening, fragmentation, cystic-like changes, and wedging.

摘要

31例先天性马蹄内翻足(CTEV)患儿经手法矫正、低敏胶带及石膏固定非手术治疗成功后,49足接受了随访。随访时,患者年龄在4.2岁至12.3岁之间(平均8.3岁)。畸形的初始类型如下:I型(轻度)18足;II型(中度)29足;III型(重度)2足。畸形仅残留的表现为:5足有轻度前足旋后,3足有孤立性凹陷,2足有大于生理性的内收。22足存在踝关节背屈缺失或受限。仅3足的Beatson-Pearson指数<40度。17足的X线片显示距舟关节在矢状面和水平面完全复位。第一跖跗关节角和胫跟角的平均值符合标准。最典型的骨改变涉及足舟骨(22足),表现为骨化中心减小、变平、碎裂、类囊性改变和楔形变。

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