Bleck E E
Clin Orthop Relat Res. 1977 Jun(125):119-30.
Twenty-one patients with resistant or relapsed clubfeet, ranged in age from four months to 7 years, and all had initially been treated with plaster by board certified orthopaedic surgeons. Surgery was recommended only after an Achilles tenotomy failed to bring the foot into dorsiflexion after approximately four months of age. Surgical correction was based upon the derotation and dorsiflexion of the talus in the ankle mortise. The criteria for a satisfactory result were: no recurrence of the equinus or varus; neutral position of the heel; dorsiflexion of the ankle to at least neutral; a fairly straight forefoot so that the center line of the foot bisected either the second or third toes or passed no further laterally than the third and fourth toes. Of the 33 feet surgically treated, 28 had satisfactory results following the first procedure, and five required additional procedures.
21例患有顽固性或复发性马蹄内翻足的患者，年龄从4个月至7岁不等，所有患者最初均由获得董事会认证的骨科医生用石膏进行治疗。仅在跟腱切断术在大约4个月大后未能使足部背屈时才建议进行手术。手术矫正基于距骨在踝关节窝内的旋转和背屈。满意结果的标准为：马蹄足或内翻无复发；足跟处于中立位；踝关节背屈至少至中立位；前足相当直，使足的中心线平分第二或第三趾，或向外侧延伸不超过第三和第四趾。在接受手术治疗的33只足中，28只在首次手术后取得了满意结果，5只需要额外的手术。
