广泛软组织松解和环形外固定器矫正先天性垂直距骨的疗效比较  

Comparison of the curative effect of extensive soft tissue release and circular external fixator in the correction of congenital vertical talus

作　　者：胡新永 陈建文 于凤章 刘伯鑫 杨曙光 成永忠[2] Hu Xinyong;Chen Jianwen;Yu Fengzhang;Liu Baixin;Yang Shuguang;Cheng Yongzhong(Orthopaedic Department of Rehabilitation Hospital,National Research Center for Rehabilitation Technical Aids,Beijing 100176,China;Trauma department of orthopedics,Wangjing Hospital of China Academy of Chinese Medical Science,Beijing 100102,China)

机构地区：[1]国家康复辅具研究中心附属康复医院骨科,北京100176 [2]中国中医科学院望京医院创伤骨科,北京100102

出　　处：《足踝外科电子杂志》2020年第1期25-28,共4页Electronic Journal of Foot and Ankle Surgery

基　　金：北京市科学技术委员会2016年首都临床特色应用研究与成果推广项目,(编号:Z161100000516111)。

摘　　要：目的比较广泛软组织松解手术和外固定器技术矫正先天性垂直距骨的效果。方法回顾性收集2005年10月—2017年1月34例儿童先天性垂直距骨患者(49足)的临床资料。依据治疗方法将患者分为A组和B组。A组25足采用广泛软组织松解手术复位距骨-舟骨关节。B组24足采用外固定器技术复位距骨-舟骨关节。采用Adelaar评分标准评估先天性垂直距骨广泛软组织松解手术和外固定器矫正的临床外观、功能和影像学结果。结果全部病例随访3~14年,平均4.2年。广泛软组织松解手术组优良率为80.0%,外固定器组为91.7%,二者比较,差异无统计学意义(χ^2=0.58,P>0.05)。广泛软组织松解手术组距舟关节半脱位率为12.0%,外固定器组距舟关节为45.8%,二者比较,差异有统计学意义(χ^2=5.31,P<0.05)。结论广泛软组织松解手术和外固定器均是矫正2~5岁先天性垂直距骨的有效方法,但外固定器矫正先天性垂直距骨有较高的距舟关节半脱位率。Objective To compare the effect of extensive soft tissue release and external fixator in the correction of congenital vertical talus.Methods The clinical data of 34 children with congenital vertical talus(49 feet)from October 2005 to January 2017 were collected retrospectively.The patients were divided into group A and group B according to the treatment method.In group A,25 feet were treated with extensive soft tissue release.In group B,24 feet were treated with external fixator.Evaluation of clinical appearance,function and imaging results of extensive soft tissue release and external fixator correction of congenital vertical talus by Adelaar scoring standard.Results All cases were followed up for 3 to 14 years,with an average of 4.2 years.The excellent and good rate of the operation group was 80.0%,and that of the external fixator group was 91.7%.There was no significant difference between them(χ^2=0.58,P>0.05).The rate of subluxation was 12.0%in the operation group and 45.8%in the external fixator group.The difference was statistically significant(χ^2=5.31,P<0.05).Conclusion Extensive soft tissue release and external fixator are both effective methods for the correction of congenital vertical talus at the age of 2-5 years.However,external fixator has a high rate of subluxation in the treatment of congenital vertical talus.

关 键 词：先天性垂直距骨 广泛松解术 环形外固定器 

分 类 号：R682.16[医药卫生—骨科学]