分期Ilizarov技术肌腱转移矫正儿麻后遗重度足畸形  

Staged Ilizarov technique and tendon transfer for correction of severe foot deformity secondary to poliomyelitis

作　　者：崔锁明 祁伟 黄超 栾峰 CUI Suo-ming;QI Wei;HUANG Chao;LUAN Feng(Zhenjiang 359 Hospital,Zhenjiang 212001,China)

机构地区：[1]镇江三五九医院,江苏镇江212001

出　　处：《中国矫形外科杂志》2023年第7期667-669,共3页Orthopedic Journal of China

摘　　要：[目的]探讨分期Ilizarov技术肌腱转移治疗儿麻后遗症重度足下垂内翻畸形的临床疗效。[方法]回顾性分析2012年6月—2018年6月本院一期行跟腱延长联合Ilizarov技术矫正足下垂内翻畸形、二期行胫后肌外移术维持软组织肌力平衡治疗的24例儿麻后遗症重度足下垂内翻畸形患者的临床资料。[结果]所有患者均顺利完成手术,术中未出现神经、血管损伤等严重并发症。所有患者随访时间平均(2.6±0.8)年。术后8个月和末次随访时,踝背伸-跖屈关节活动度较术前改善明显(P<0.05),AOFAS踝-后足评分较术前显著增加(P<0.05)。影像方面,与术前相比,术后8个月和末次随访时,踝关节退变分级Morrey-Wiedeman均较术前显著改善(P<0.05)。[结论]分期Ilizarov技术肌腱转移矫正儿麻后遗症重度足下垂内翻畸形疗效确切。[Objective] To investigate the clinical efficacy of staged Ilizarov technique and tendon transfer in the treatment of severe talipes equinovarus deformity secondary to poliomyelitis.[Methods] A retrospective study was conducted on 24 patients who received Achilles tendon lengthening combined with Ilizarov technique to correct the deformities in the first stage,followed by transfer of posterior tibialis to maintain muscle balance in the second stage for talipes equinovarus deformity secondary to poliomyelitis in our department from June 2012to June 2018.[Results] All patients had two-stage surgical procedures and relative interoperative management performed successfully with no serious complications such as nerve and vascular injury during the preoperative period.As time went in the follow-up period lasted for(2.6±0.8) years on an average,the range of motion of ankle dorsi flexion and metatarsal flexion joint significantly improved(P<0.05),the AOFAS ankle-hindfoot score significantly improved(P<0.05).In term of radiograph,Morrey-Wiedeman classification of ankle degeneration were significantly improved at 8 months after operation and at the last follow-up compared with those before operation(P<0.05).[Conclusion] The staged Ilizarov technique and tendon transfer are effective treatment for correction of severe talipes equinovarus deformity secondary to poliomyelitis.

关 键 词：儿麻后遗症 重度足下垂内翻畸形 ILIZAROV技术 肌腱转移 

分 类 号：R682.16[医药卫生—骨科学]