Ponseti法治疗先天性马蹄内翻足经皮跟腱切断术后跟腱愈合的超声评价  

Ultrasonographic evaluation in gap healing after Achilles tenotomy by Ponseti′s technique

作　　者：张勇 史宁宁 吴守振[3] 刘百灵[4] 陶惠人 Zhang Yong;Shi Ningning;Wu Shouzhen;Liu Bailing;Tao Huiren(Department of Orthopedics,Shenzhen University General Hospital,Shenzhen 5188055,China)

机构地区：[1]深圳大学总医院骨科,518055 [2]深圳大学总医院手术室,518055 [3]西安市儿童医院儿研所 [4]西安市儿童医院超声科

出　　处：《山西医药杂志》2018年第15期1756-1758,共3页Shanxi Medical Journal

摘　　要：目的应用B超评价Ponseti方法治疗特发性先天性马蹄内翻足经皮跟腱切断术后跟腱的愈合情况。方法对26例特发性先天性马蹄内翻足患儿(38只马蹄足),采用Ponseti法矫形,经系列石膏纠正前足内收和跟骨内翻畸形,采用经皮跟腱切断,石膏固定纠正残留马蹄畸形,常规术后三周拆除石膏,并应用超声在经皮跟腱切断术前,术后3周,术后6周,术后9周对跟腱进行连续测评,并对患儿超声图像进行比较分析,观察跟腱的愈合情况,分析影响跟腱愈合的因素。结果 26例特发性先天性马蹄内翻足患儿行经皮跟腱切断术时的日龄为42~296d,38只马蹄足经Ponseti法矫正后均获得满意效果。超声图像显示38只马蹄足术后3周跟腱均有不同程度点片状纤维组织再生,并未恢复连续性,术后6周可见丰富的纤维组织再生,跟腱恢复连续性,术后9周跟腱恢复完整性。结论经皮跟腱切断术后3周跟腱已有不同程度的再生,术后9周跟腱可恢复完整性。跟腱完全愈合所需时间尚需进一步研究。Objective To study the tendon gap healing and how the healing varies after performing percutaneous tenotomy by Ponseti′s technique. Methods Thirty-eight clubfeet in twenty-six patients with idiopathic congenital clubfoot were treated by Ponseti′s method.Clinical and ultrasound evaluations were performed at three weeks,six weeks and nine weeks after the tenotomy to assess the regeneration of the tendon.Results The Ponseti′s method corrected all feet.The patients aged 42-296 days were examined at three,six and nine weeks after the tenotomy.Ultrasonography showed there were occasionally,randomly arranged fibers in the gap zone at three weeks.Six weeks after tenotomy,fibers were observed more frequently and the tendon recovered a linear structure but thinner than a normal one.Nine weeks after tenotomy,ultrasonography showed an integrated tendon that was similar to a normal one.Conclusion Fibers regeneration was observed occasionally in the gap zone at three weeks after tenotomy,an integrated tendon that was similar to a normal one was not seen until nine weeks,the time for the tendon to completely heal still requires further studies.

关 键 词：马蹄内翻足 PONSETI方法 超声检查 跟腱切断 愈合 

分 类 号：R726.8[医药卫生—儿科]