D'Souza H, Aroojis A, Chawara G S
Children's Orthopaedic Hospital, Mumbai, India.
J Pediatr Orthop. 1998 Nov-Dec;18(6):760-4.
Talectomy is recommended as a primary or salvage procedure for management of rigid or recurrent equinovarus deformity in arthrogryposis. Twenty-one feet (11 children) that had undergone talectomy were reviewed at a mean follow-up of 11.1 years (range, 2-24). Fourteen (73.7%) feet were satisfactory at final review, whereas five (26.3%) had an unsatisfactory result. Attention to technical details and accurate positioning of calcaneus in the ankle mortise are the two important prerequisites to guarantee a satisfactory long-term result. Fusion of the tibiocalcaneal articulation in optimal position, either spontaneous or induced, is a favorable sign, as it ensures lasting correction of the deformity. The role of a tight and fibrotic tibialis anterior in causing recurrence of severe forefoot adduction and supination is discussed.
对于先天性多发性关节挛缩症中僵硬或复发性马蹄内翻畸形的治疗，距骨切除术被推荐作为一种主要或挽救性手术。对21只接受距骨切除术的足（11名儿童）进行了回顾性研究，平均随访时间为11.1年（范围2 - 24年）。在最终复查时，14只足（73.7%）结果满意，而5只足（26.3%）结果不满意。关注技术细节以及跟骨在踝关节窝中的准确定位是保证长期满意结果的两个重要前提。胫距关节在最佳位置融合，无论是自发融合还是诱导融合，都是一个有利迹象，因为它能确保畸形得到持久矫正。文中讨论了紧张且纤维化的胫前肌在导致严重前足内收和旋后复发中的作用。
