Smith W A, Campbell P, Bonnett C
Orthop Clin North Am. 1976 Oct;7(4):889-93.
Eighty-one patients (116 clubfeet) underwent posterior ankle release before the age of two years, following unsatisfactory responses to serial corrective casts applied according to the technique of Kite. Seventy-three per cent of these feet showed no or only mild talar flattening at an average follow-up of 7.5 years. Four years, following posterior ankle release there was a none-mild talar flattening rate of 69 per cent in this group compared to a 40 per cent none-mild rate in ankle release reduces the incidence of recurrent equinus deformity and the necessity for subsequent surgery in comparison to the results obtained with serial plaster casts or with tendo Achillis lengthening alone. Recent trends in clubfoot management have favored increasingly early operative intervention. Denham stated that "In the infant hard tissues (bone and cartilage) should be regarded as soft, and the soft tissues (tendon and ligament) as hard." Our operative experience with posterior ankle release supports this philosophy and indicates that early aggressive surgical management is the treatment of choice for the resistant clubfoot.
81例患者（116只畸形足）在两岁前接受了后踝松解术，此前按照Kite技术应用的系列矫正石膏治疗效果不佳。在平均7.5年的随访中，这些足部中有73%未出现或仅出现轻度距骨扁平。与单独跟腱延长或系列石膏治疗的结果相比，后踝松解术后四年，该组非轻度距骨扁平率为69%，而单独跟腱延长组为40%。后踝松解术降低了复发性马蹄畸形的发生率以及后续手术的必要性。近期畸形足治疗的趋势越来越倾向于早期手术干预。Denham指出：“在婴儿中，硬组织（骨骼和软骨）应视为软组织，而软组织（肌腱和韧带）应视为硬组织。”我们后踝松解术的手术经验支持这一理念，并表明早期积极的手术治疗是顽固性畸形足的首选治疗方法。
