先天性马蹄内翻足Ponseti疗法治疗初经皮跟腱切断术的预测  

作　　者：孙克明[1] 姚满叶[1] 季泽娟[1] 

机构地区：[1]河南省郑州市儿童医院骨科,450053

出　　处：《当代医学》2012年第32期99-100,共2页Contemporary Medicine

摘　　要：目的探讨先天性马蹄内翻足(CCF)患儿治疗前如何预测患儿行跟腱手术的可能性。方法 173足CCF(133例),均依据Ponseti方法治疗。每例治疗前、中、后都据Dimeglio评分系统进行评分。结果 173足中有131例需性经皮跟腱切断术,占治疗足的75.7%,经皮跟腱切断手术组手术前石膏矫形平均次数为8.5(5～10)次,未行手术组的石膏矫形次数为平均4.1(3～6)(5.0±1.1)次(P<0.001),治疗前IV组51足,其中48足(94.1%)行经皮跟腱切断手术,在去除最后一次石膏时,据Dimeglio评分系统再次评分,两组没有显著差异。结论 Dimeglio评分IV级的CCF,绝大多数需要经皮跟腱切断术。需要经皮跟腱切断术的CCF,同不需要切断术CCF一样,在最后一次石膏去除后,畸形都能被完全矫正。Objective The purpose of this study was to determine how to predict the need for tenotomy at the initiation of the Ponseti treatment. Methods 173 clubfeet （35 patients） were prospectively rated according to Dimeglio scoring systems, who were consecutively treated.The treatment was consisted of weekly manipulations and serial long leg cast, as described by Ponseti. Results Tenotomies were performed in 131 of173 feet （75.7%）. Those that underwent tenotomy required significantly more casts （P〈0.001）. 94.7% of the Dimeglio Grade IV feet required tenotomies. Following removal of the last cast, there was no significant difference between those that did and did not have a tenotomy. Conclusion Children with clubfeet who have an initial score are rated as Grade IV feet by the Dimeglio system are very likely to need a tenotomy. At the end of casting, feet were equally well corrected whether or not they needed a tenotomy.

关 键 词：畸形足 先天性 石膏 外科 跟腱切断手术 Dimeglio评分 

分 类 号：R726.8[医药卫生—儿科]