Vispo Seara J L, Arnold J P, Lorenz M, Krauspe R
Orthopädische Universitätsklinik Würzburg, König-Ludwig-Haus.
Z Orthop Ihre Grenzgeb. 1996 Nov-Dec;134(6):533-6. doi: 10.1055/s-2008-1039920.
A doppler ultrasound study investigated vascularity in congenital idiopathic clubfeet (talipes equinovarus, (TEV) pretreated only by casting and physiotherapy. The studies were performed on 40 TEV (27 patients) aged 4-72 months (average 15.1). In 12 unilateral cases of TEV, the opposite normal foot and 74 normal feet of 37 healthy children aged 3-35 months (average 8.7) were used as controls. Dorsalis pedis (DP), posterior tibial (PT), and peroneal (P) pulses were recorded by an unidirectional 8 MHZ continuous wave technique. At rest, DP pulses and PT pulses were present in all investigated TEVs. P pulse was absent in only one case of TEV. In the group of controls DP pulse was absent in one case and P pulse was absent in an other case of normal foot with contralateral TEV. All the other pulses in normal feet were present at physiological location. We propose that a vascular etiology for the origin of congenital idiopathic clubfoot, as reported in literature, is unlikely. The influence of postnatal casting in TEV on the vascular arterial condition is slight or even absent. Doppler assessment is readily available, noninvasive, and a reproducible mean of monitoring vascular integrity in clubfeet. Relating to vascular complications after surgery, perhaps caused by a preextant arterial anomaly, doppler assessment is indicated routinely in syndromes of multiple malformations with clubfoot deformity before surgical treatment. In congenital idiopathic clubfeet it is not necessary as a routine check.
一项多普勒超声研究调查了仅接受石膏固定和物理治疗的先天性特发性马蹄内翻足（畸形足，TEV）的血管情况。该研究对40例年龄在4至72个月（平均15.1个月）的TEV（27例患者）进行。在12例单侧TEV病例中，将对侧正常足以及37名年龄在3至35个月（平均8.7个月）的健康儿童的74只正常足作为对照。采用单向8兆赫连续波技术记录足背动脉（DP）、胫后动脉（PT）和腓动脉（P）搏动。静息时，所有被调查的TEV均能记录到DP搏动和PT搏动。仅1例TEV未记录到P搏动。在对照组中，1例正常足未记录到DP搏动，1例对侧为TEV的正常足未记录到P搏动。正常足的所有其他搏动均位于生理位置。我们认为，文献中报道的先天性特发性马蹄内翻足起源的血管病因不太可能成立。产后石膏固定对TEV血管动脉状况的影响轻微甚至不存在。多普勒评估易于进行、无创，是监测马蹄内翻足血管完整性的可重复方法。关于手术后可能由先前存在的动脉异常引起的血管并发症，在手术治疗前，对于伴有马蹄内翻足畸形的多发畸形综合征，常规应进行多普勒评估。在先天性特发性马蹄内翻足中，无需作为常规检查。
