胫骨远端前侧半骨骺阻滞术治疗儿童僵硬性马蹄内翻足矢状面跖屈畸形的短期效果  

Short-term efficacy of anterior distal tibial semi-epiphyseal block in treating sagittal plantar flexion deformity in children with equionvarus foot

作　　者：王军 杨翔宇 赵鼎 蔡豪杰 聂玉婷 朱光辉 杨戈 刘昆 严安 谭谦 叶卫华 唐进 梅海波 莫莎莎 Wang Jun;Yang Xiangyu;Zhao Ding;Cai Haojie;Nie Yuting;Zhu Guanghui;Yang Ge;Liu Kun;Yan An;Tan Qian;Ye Weihua;Tang Jin;Mei Haibo;Mo Shasha(Department of Orthopedics,Affiliated Children's Hospital,Xiangya School of Medicine,Central South University(Hunan Children's Hospital),Hunan Provincial Key Laboratory of Pediatric Orthopedics,The School of Pediatrics,University of South China,Changsha 410007,China)

机构地区：[1]中南大学湘雅医学院附属儿童医院(湖南省儿童医院)骨科,儿童骨科学湖南省重点实验室,南华大学儿科学院,长沙410007

出　　处：《临床小儿外科杂志》2024年第11期1019-1022,共4页Journal of Clinical Pediatric Surgery

基　　金：儿童骨科学湖南省重点实验室(2023TP1019);芙蓉实验室科技项目(2023SK2111);湖南省儿童肢体畸形临床医学研究中心(2019SK4006)。

摘　　要：目的评价胫骨远端前侧半骨骺阻滞术治疗儿童僵硬性马蹄内翻足矢状面跖屈畸形的短期效果。方法回顾性分析湖南省儿童医院2018年2月至2022年3月采用胫骨远端前侧半骨骺阻滞术治疗的僵硬性马蹄内翻足患儿临床资料。记录手术前、取内固定时踝关节背伸活动角度、踝关节侧位X线胫骨远端前侧角(anterior distal tibial angle,ADTA)及并发症发生情况。结果共5例(7足)纳入研究,均为男性,平均年龄10岁4个月(范围:7岁11个月至12岁4个月)。胫骨远端内固定平均留置时间26.2个月(范围:15~36个月)。5例均获得跖行足。术前ADTA(87.43±3.15)°、取内固定时ADTA(72.43±5.56)°,差异有统计学意义(P<0.05);术前踝关节背伸(-15.00±14.72)°、取内固定时踝关节背伸(14.29±8.86)°,差异有统计学意义(P<0.05)。1例出现内固定螺钉松动。5例均未发生内固定断裂、感染、踝关节半脱位、骨桥形成等并发症。结论胫骨远端前侧半骨骺阻滞术治疗儿童僵硬性马蹄内翻足矢状面跖屈畸形的短期疗效良好。ObjectiveTo evaluate the short-term effects of anterior distal tibial semi-epiphyseal block surgery in treating sagittal plantar flexion deformity in children with equinovarus foot.MethodsA retrospective analysis of the data of children with equinovarus foot treated with anterior distal tibial semi-epiphyseal block at Hunan Children's Hospital from February 2018 to March 2022.The preoperative and intraoperative angles of ankle dorsiflexion and anterior distal tibial angle(ADTA)on lateral X-rays were recorded,along with the occurrence of complications.ResultsA total of 5 cases(7 feet)were included,all male,with an average age of 10 years and 4 months(range:7 years and 11 months to 12 years and 4 months).The average duration of internal fixation was 26.2 months(range:15 to 36 months).All 5 cases achieved a plantigrade foot.The preoperative ADTA was(87.43±3.15)°,and the ADTA at the time of internal fixation removal was(72.43±5.56)°,with a statistically significant difference(P<0.05);the preoperative ankle dorsiflexion was(-15.00±14.72)°,and at the time of internal fixation removal,it was(14.29±8.86)°,also with a statistically significant difference(P<0.05).One case experienced screw loosening,but no cases had complications such as internal fixation fracture,infection,ankle subluxation,or bridge formation.ConclusionsAnterior distal tibial semi-epiphyseal block surgery demonstrates good short-term efficacy in treating sagittal plantar flexion deformity in children with equinovarus foot.

关 键 词：半骨骺阻滞 僵硬性马蹄足 外科手术 儿童 

分 类 号：R68[医药卫生—骨科学]