Vogt J C
Clinique des Diaconesses, Strasbourg, France.
J Foot Ankle Surg. 1998 Jan-Feb;37(1):2-7; discussion 78. doi: 10.1016/s1067-2516(98)80003-3.
The aim of this study was to describe the long-term results of split tibialis transfer in patients with stroke, cerebral palsy, and brain damage due to trauma, tumor, or infection. An evaluation was made of 73 feet in 69 patients with tendon transfer or lengthening for an average follow-up period of 44 months (range, 1 to 14 years). The primary indications for surgery included pain caused by pressure of the foot or toes on the floor or in shoes, ankle instability due to varus deformity, or difficulty wearing orthopedic shoes or braces chi(2) tests were used to compare preoperative and postoperative autonomy, and shoe and orthosis requirements. The results of this study include significant improvement in patient autonomy (p < 0.001), demonstrated by an improved ability to ambulate independently and a decreased need to wear orthopedic shoes (p < 0.001) and orthoses (p < 0.001), as well as an increased ability to wear normal shoes (p < 0.001). This procedure is safe and yields good results with minimal complications. The indications are very common, inasmuch as the number of young hemiplegic or tetraplegic patients surviving after a stroke or head injury is increasing. This procedure can result in definite improvement for these disabled patients and can increase their autonomy.
本研究旨在描述中风、脑瘫以及因创伤、肿瘤或感染导致脑损伤患者行胫后肌转移术的长期效果。对69例患者的73只脚进行了评估，这些患者均接受了肌腱转移或延长手术，平均随访期为44个月（范围1至14年）。手术的主要适应证包括因足部或脚趾与地面或鞋子接触受压所致疼痛、因内翻畸形引起的踝关节不稳，或穿戴矫形鞋或支具困难。采用卡方检验比较术前和术后的自主能力、鞋类及矫形器需求情况。本研究结果显示，患者的自主能力有显著改善（p < 0.001），表现为独立行走能力提高，穿戴矫形鞋（p < 0.001）和矫形器的需求减少（p < 0.001），以及穿正常鞋子的能力增强（p < 0.001）。该手术安全，并发症少，效果良好。鉴于中风或头部受伤后存活的年轻偏瘫或四肢瘫痪患者数量不断增加，这些适应证非常常见。该手术可为这些残疾患者带来明显改善，并提高他们的自主能力。
