两种方法治疗儿童僵硬性马蹄内翻足的中期效果评价  

Mid-term result of two techniques in management of congenital rigid clubfoot in children

作　　者：朱光辉[1] 梅海波[1] 赫荣国[1] 刘昆[1] 唐进[1] 伍江雁[1] 叶卫华[1] 胡欣[1] 谭谦[1] 严安[1] 黄生祥[1] 谭晓谦[1] 雷霆[1] 张妮[1] 

机构地区：[1]湖南省儿童医院骨科,湖南省长沙市410007

出　　处：《临床小儿外科杂志》2015年第2期110-112,120,共4页Journal of Clinical Pediatric Surgery

基　　金：湖南省科技厅课题（湘财教指[2009]42号）

摘　　要：目的：评价 Ponseti 方法和足后内侧软组织松解手术治疗儿童僵硬性马蹄内翻足的中期效果。方法对本院2005年4月至2010年6月收治的僵硬性马蹄内翻足病例资料进行回顾性研究。按照治疗方法的不同，分为 Ponseti 方法组和足后内侧软组织松解手术组。按 Pirani 系统进行评分。术后使用 Laaveg 和 Ponseti 功能评分系统（FRS）进行效果评价。结果共43例（55足）纳入研究，23例（28足）采用 Ponseti 方法治疗，随访时间50-82个月，平均67个月。20例（27足）采用后内侧软组织松解术治疗，随访时间56-90个月，平均75个月。治疗开始时两组 Pirani 评分之间无显著差异（P ＞0．05）。两组治疗前后 Pirani 评分显著减小（P ＜0．05）。Ponseti 方法组有更高的 FRS 评分（P ＜0．01）。Ponseti 方法组的最大被动背伸活动度评分更高（P ＜0．01）。两组影像学结果相似。但 Ponseti 方法组的复发率较软组织松解手术组的复发率低。结论与后内侧软组织松解术相比，Ponseti 方法治疗儿童僵硬性马蹄内翻足的中期效果更好。Objective To evaluate the middle-term outcome of Ponseti method and posteromedial re-lease in management of congenital rigid clubfoot in children. Methods A retrospective control study on the patients with congenital rigid clubfoot admitted was conducted during April,2005 to June,2010.The cases were divided into 2 groups by the different technique：Ponseti method and posteromedial release group.the patients were scored by Pirani score system.the Function Rating System （FRS）of Laaveg and Ponseti were used to as-sess the outcome. Results There were 43 cases （55 feet）enrolled in our study.23 cases （28 feet）were treated by Ponseti method with a mean follow up of 67 months （range,50 -82 months）while 20cases （27 feet）were managed by posteromedial release with a mean follow up of 75 months （range,56 -90 months）.Pi-rani Scores showed no significant differences at the beginning of treatment （P 〉0.05）.But pre-op and post-op Pirani Scores in both groups decreased significantly （P 〈0.05）.The FRS total score in the Ponseti group was higher than the posteromedial release group （P 〈0.01）.Passive maximal dorsiflexion scored higher in Ponseti group.The radiographic variables were similar between the groups.Recurrence rate of Ponseti group was lower than the posteromedial release group. Conclusions Compared with posteromedial release,Ponseti method has a favorable mid-term outcome in management of congenital rigid clubfoot in children.

关 键 词：畸形足 外科手术/方法 评价研究 儿童 

分 类 号：R726.826[医药卫生—儿科]