Ilizarov技术矫治儿童马蹄内翻足畸形  

Ilizarov technique in correction of the talipes equinovarus in children

作　　者：陈建文[1] 秦泗河 焦绍锋[1] 吴鸿飞[1] 郑学建[1] 王振军[1] 

机构地区：[1]北京市垂杨柳医院,100024

出　　处：《中华小儿外科杂志》2010年第5期350-353,共4页Chinese Journal of Pediatric Surgery

基　　金：首都医学发展科研基金资助（No.2005-3063）及北京市朝阳区科技计划资助（No.SF0804）

摘　　要：目的 探讨应用Ilizarov技术矫治儿童严重及僵硬性马蹄内翻足畸形的一些临床问题.方法 2002年5月至2009年3月,应用Ilizarov的组织牵伸技术,结合传统的外科手段,共治疗严重及僵硬的儿童马蹄内翻足畸形28例（32足）,患儿平均年龄8.1岁.设计特殊的足踝牵伸器,分析足的畸形状态,进行合理的安装.参照Ponseti的手法矫治原则,逐步缓慢牵伸至畸形完全矫正.矫治结束后,进行必要的石膏、支具固定以预防畸形的复发.结果 28例（32足）均获得完全矫正,无严重的并发症.20例（24足）获得6个月以上的随访,平均14个月;轻度复发6个足,马蹄均〈20°;踝关节活动度保持良好,足的僵硬度均未有增加,多有所改善.根据国际马蹄足畸形研究学组（ICFSG）的评分系统：优9足,良11足,可4足,差0足.结论 利用Ilizarov组织牵伸技术充分调动儿童存在的生长潜能,矫治严重及僵硬的儿童马蹄内翻足畸形创伤小、风险低,可以保留足的外观,恢复其跖行的功能,达到理想的矫正效果.Objective To investigate the clinical efficacy of Ilizarov technique in correction of severe and stiff talipes equinovarus in children.Methods Between May 2002 and March 2009,32 severe and stiff equinovarus feet of 28 children with an average age of 8.1 years,underwent surgical correction using Ilizarov tissue distraction technique combining conventional surgical treatments.Before fixation,special distraction apparatus of the foot-ankle were designed according to the talipedic deformity appearance.Gradual and slow distraction was applied until the deformities were completely corrected.The fixation of plaster and orthosis were applied on some patients to prevent late recurrence of the deformities.Results Deformities of all patients＇feet were completely corrected without any serious complications.Twenty patients（24 deformed feet）have been followed up for an averaged period of 14 months.Among the 24 feet,mild equines less than 20 recurred on 6 feet.All 24 feet kept good ankle joint motion.The treatments improved the stiffness in most cases.Using the International Clubfoot Study Group（ICFSG）grading system,9 feet were graded as excellent,11 good and 4 fair.Conclusions Ilizarov tissue distraction is a safe and minimally invasive surgical procedure to correct pediatric severe and stiff equinovarus.

关 键 词：马蹄内翻足 伊利扎罗夫技术 

分 类 号：R726.8[医药卫生—儿科]