中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2013年
2期
123-126
,共4页
婴儿%马蹄内翻足%Ponseti法
嬰兒%馬蹄內翻足%Ponseti法
영인%마제내번족%Ponseti법
Infant%Clubfoot%Ponseti method
目的 观察婴儿特发性马蹄内翻足Ponseti法矫正后平均5年的随访结果.方法 回顾分析2005年3月至2008年6月,我院骨科采用Ponseti方法治疗先天性马蹄内翻足连续病例,入选标准:①先天性马蹄内翻足(生后即有足内翻畸形)；②首次治疗时年龄0～12个月；③仅采用Ponseti方法矫正.排除标准；①治疗及随访过程中发现其他运动神经系统畸形:多关节挛缩症,髋关节脱位、膝关节脱位、羊膜束带、脊髓栓系、脊膜膨出,脑发育不良等；②就诊前曾采用其他方法治疗.临床结果的判定,优:跖行,无痛,行走生活良好,已行,或未行跟腱切断术；良:已行或已决定行胫前肌外移等非涉及关节囊的矫形手术者；差:已行或已决定行后内侧软组织松解术者.结果 经病史分析得到56例76足符合标准.其中男42例,女14例,双足20例,单足36例(左侧11足,右侧25足),共计76足.随访年限最短3年,最长6年,平均5年.76足中62足(81.6％)临床结果为优,6足(7.9％)临床结果为良,8足(10.5％)临床结果为差.以患儿就诊时年龄是否超过3个月分为两组,两组均为38足,小年龄组中29/38 (76.3％)为优,5/38(13.1％)为良,4/38(10.5％)为差,大年龄组中33/38(86.8％)为优,1/38(2.6％)为良,4/38(10.5％％)为差,两组结果差异无统计学意义.结论 ①特发性马蹄内翻足采用Ponseti法矫正后在平均5年随访时,81.6％的足为优,7.9％的足为良,10.5％的足为差(需要行后内侧软组织松解术)；②在4～12个月之间开始矫形的特发性马蹄内翻足中,在平均5年随访时与0～3个月之间开始矫正的患儿相比,临床结果差异没有统计学意义.
目的 觀察嬰兒特髮性馬蹄內翻足Ponseti法矯正後平均5年的隨訪結果.方法 迴顧分析2005年3月至2008年6月,我院骨科採用Ponseti方法治療先天性馬蹄內翻足連續病例,入選標準:①先天性馬蹄內翻足(生後即有足內翻畸形)；②首次治療時年齡0～12箇月；③僅採用Ponseti方法矯正.排除標準；①治療及隨訪過程中髮現其他運動神經繫統畸形:多關節攣縮癥,髖關節脫位、膝關節脫位、羊膜束帶、脊髓栓繫、脊膜膨齣,腦髮育不良等；②就診前曾採用其他方法治療.臨床結果的判定,優:蹠行,無痛,行走生活良好,已行,或未行跟腱切斷術；良:已行或已決定行脛前肌外移等非涉及關節囊的矯形手術者；差:已行或已決定行後內側軟組織鬆解術者.結果 經病史分析得到56例76足符閤標準.其中男42例,女14例,雙足20例,單足36例(左側11足,右側25足),共計76足.隨訪年限最短3年,最長6年,平均5年.76足中62足(81.6％)臨床結果為優,6足(7.9％)臨床結果為良,8足(10.5％)臨床結果為差.以患兒就診時年齡是否超過3箇月分為兩組,兩組均為38足,小年齡組中29/38 (76.3％)為優,5/38(13.1％)為良,4/38(10.5％)為差,大年齡組中33/38(86.8％)為優,1/38(2.6％)為良,4/38(10.5％％)為差,兩組結果差異無統計學意義.結論 ①特髮性馬蹄內翻足採用Ponseti法矯正後在平均5年隨訪時,81.6％的足為優,7.9％的足為良,10.5％的足為差(需要行後內側軟組織鬆解術)；②在4～12箇月之間開始矯形的特髮性馬蹄內翻足中,在平均5年隨訪時與0～3箇月之間開始矯正的患兒相比,臨床結果差異沒有統計學意義.
목적 관찰영인특발성마제내번족Ponseti법교정후평균5년적수방결과.방법 회고분석2005년3월지2008년6월,아원골과채용Ponseti방법치료선천성마제내번족련속병례,입선표준:①선천성마제내번족(생후즉유족내번기형)；②수차치료시년령0～12개월；③부채용Ponseti방법교정.배제표준；①치료급수방과정중발현기타운동신경계통기형:다관절련축증,관관절탈위、슬관절탈위、양막속대、척수전계、척막팽출,뇌발육불량등；②취진전증채용기타방법치료.림상결과적판정,우:척행,무통,행주생활량호,이행,혹미행근건절단술；량:이행혹이결정행경전기외이등비섭급관절낭적교형수술자；차:이행혹이결정행후내측연조직송해술자.결과 경병사분석득도56례76족부합표준.기중남42례,녀14례,쌍족20례,단족36례(좌측11족,우측25족),공계76족.수방년한최단3년,최장6년,평균5년.76족중62족(81.6％)림상결과위우,6족(7.9％)림상결과위량,8족(10.5％)림상결과위차.이환인취진시년령시부초과3개월분위량조,량조균위38족,소년령조중29/38 (76.3％)위우,5/38(13.1％)위량,4/38(10.5％)위차,대년령조중33/38(86.8％)위우,1/38(2.6％)위량,4/38(10.5％％)위차,량조결과차이무통계학의의.결론 ①특발성마제내번족채용Ponseti법교정후재평균5년수방시,81.6％적족위우,7.9％적족위량,10.5％적족위차(수요행후내측연조직송해술)；②재4～12개월지간개시교형적특발성마제내번족중,재평균5년수방시여0～3개월지간개시교정적환인상비,림상결과차이몰유통계학의의.
Objective To report the clinical outcome at 5 years of infants with idiopathic clubfeet treated by Ponseti Method from one center in Shanghai,China Methods A cohort of consecutive children with clubfeet treated by Ponseti method from March 2005 to June 2008 was reviewed retrospectively.To be included in this study,all the patients were under 12 months of age when treatment was begun,had idiopathic clubfeet deformities,and had not undergone previous treatment.Teratologic and paralytic clubfoot deformities were not included.Outcomes were classified as Good (plantigrade foot with or without a tendoachilles lengthening),Fair (limited surgery),or Poor(posteromedial release).Results 56 patients(42 Male: 14 Female) with 76 clubfeet were identified.20 patients were bilateral and 36 patient ware unilateral.The clinical outcome at an average of 5-years (minium of 3 years),were reported.Among the 76 clubfeet,62 feet (81.6％) were graded as Good,6 feet (9.7％) were Fair and 8 feet (10.5％) were Poor.There was no statistically significant difference between the two groups even if the patients were further broken down by whether they started treatment before 3 months of age.Conclusions Satisfactory outcome of infantile idiopathic clubfeet treated by the Ponseti Method was seen.Patients who started treatment between 4 months and 12 months of age did not get a significant worse outcome in 5-year follow-up than those started earlier than 3 months of age.
