Kodros S A, Dias L S
Children's Memorial Hospital, Chicago, Illinois, USA.
J Pediatr Orthop. 1999 Jan-Feb;19(1):42-8.
Forty-one patients (55 feet) with congenital vertical talus (CVT) were reviewed. Thirty of the feet were associated with neural tube defects, 10 with neuromuscular disorders, five with congenital malformation syndromes, and none with chromosomal aberrations. Ten of the feet were idiopathic. All were treated with a single-stage surgical correction as described, by using the Cincinnati incision, and performed by the same surgeon. Thirty-two patients (42 feet) were available for clinical and radiographic follow-up averaging 7 years (range, 2-12) from the time of surgery. There were no wound complications or avascular necrosis of the talus. In 10 feet, subsequent reoperation was necessary. At final follow-up, results were based on the clinical and radiographic outcomes and included 31 good and 11 fair. All patients and families were satisfied with the results and appearance of the feet. There were no bony prominences or skin problems. The presence of mild pain was noted in only three feet. Radiographically, there was a significant improvement in the anteroposterior (AP) and lateral talocalcaneal and talo-first metatarsal angles, and at follow-up, the group averages for each of these angles were within the normal range. In treating CVT, good clinical and radiographic results can be obtained with a low incidence of complications using this single-stage surgical correction of the hindfoot and midfoot deformities.
对41例(55足)先天性垂直距骨(CVT)患者进行了回顾性研究。其中30足合并神经管缺陷,10足合并神经肌肉疾病,5足合并先天性畸形综合征,无合并染色体异常者。10足为特发性。所有患者均采用所述的单阶段手术矫正治疗,采用辛辛那提切口,由同一位外科医生进行手术。32例患者(42足)可进行临床和影像学随访,平均随访时间为术后7年(范围2 - 12年)。无伤口并发症或距骨缺血性坏死。10足需要再次手术。在末次随访时,结果基于临床和影像学结果,包括31例优和11例良。所有患者及其家属对足部的结果和外观均满意。无骨突出或皮肤问题。仅3足有轻度疼痛。影像学检查显示,前后位(AP)、距跟外侧和距第一跖骨角有显著改善,随访时,这些角度的组平均数值均在正常范围内。采用这种单阶段手术矫正后足和中足畸形治疗CVT,可获得良好的临床和影像学结果,并发症发生率低。