儿童马蹄内翻足矫形术后畸形复发个体化治疗方案的疗效评价  

Effect of Individualized Treatment Strategies for Relapsed Clubfoot

作　　者：徐军奎[1] 屈福锋 赵炼 蔡杰 刘韶 李毅[1] 梁晓军[1] 刘诚[1] 赵恺[1] 姬维娜 Xu Junkui;Qu Fufeng;Zhao Lian;CAI Jie;LIU Shao;LI Yi;LIANG Xiaojun;LIU Chen;ZHAO Kai;JI Weina(Medical College Red Cross Hospital,Xi’an 710054,China;Medical College of Xi’an,Xi’an 710021,China;TCM University of Shanxi,Xi’an 712046,China)

机构地区：[1]西安交通大学医学院附属红会医院足踝外科,陕西西安710054 [2]西安医学院,陕西西安710021 [3]陕西中医药大学,陕西西安712046

出　　处：《实用骨科杂志》2018年第4期318-323,共6页Journal of Practical Orthopaedics

基　　金：西安市科技计划项目[SF1512(2)];陕西省自然科学基础研究计划(2013JM4059);陕西省科学技术研究发展计划项目(2016SF-333)

摘　　要：目的通过临床结果及影像学评价个体化方案治疗儿童马蹄内翻足矫形术后畸形复发的疗效。方法 2011年2月至2015年12月收治儿童复发性马蹄内翻足畸形28例45足,男16例25足,女12例20足;年龄5~14岁,平均9.2岁。根据每个患者畸形的分类及畸形复发的程度设计了个体化治疗方案,通过Maryland评分、VAS评分及满意度调查和影像学正位片的距骨第1跖骨角(T1MT)、跟骨第5跖骨角(C5MT),侧位片的距骨第1跖骨角(Meary’s角)、跟骨距骨角(Kite角)进行手术前后的比较。结果本研究所有患者均获得完整随访,随访时间12~33个月,平均(21.5±1.8)个月。3例(4足)术后伤口表浅感染,经过短期抗生素治疗所有伤口均愈合。末次随访时平均Maryland评分较术前明显提高(P<0.01),末次随访时平均VAS评分较术前明显降低(P<0.01);末次随访时患者满意度评价:很满意18例,满意8例,一般2例;末次随访时T1MT角、C5MT角、Meary’s角、Kite角较术前均有明显改善(P<0.01)。结论针对儿童复发性马蹄内翻足畸形患者制定个体化治疗方案能够获得满意效果。Objective To assess clinical and radiographic outcomes of individualized treatment strategies for the relapsed clubfoot.Methods From February 2011 to December 2015,a total of 28 patients(45 feet)were admitted to our hospital and treated by individual treatment strategies,which including 16 male patients(25 feet)and 12 female patients(20 feet),the mean age of the patients was 9.2 years(5 to 14).The Maryland score,VAS score,satisfaction survey,talar to first metatarsal angle(Meary’sangle),calcaneal to 5th metatarsal angle(C5MT)of AP,talar to first metatarsal angle(Meary’s angle),kite angle of lateral positon of preopration and postoperation were compared.Results All patients were followed up for 12 to 33 months,with an average of(21.5±1.8)months.3 cases(4 feet)suffered postoperative wound superficial infection,and were cured by antibiotics.The Maryland score of end time evidently improved(P<0.01).The VAS score of the end follow-up was obvously reduced(P<0.01).The satisfaction suvery of paitents showed 18 paitents were very satisfactory,8 paitents were satisfactory,and 2 paitents felt general.The angles of T1MT,T2MT,C5MT,Meary,and Kite were significantly improved(P<0.01).Conclusion The individualized treatment strategies for the patients with relapsed clubfoot deformity in children can obtain satisfactory results.

关 键 词：马蹄内翻足 畸形复发 个性化方案 手术疗效 

分 类 号：R682.16[医药卫生—骨科学]