CAJ | 학술논문

背景：国内对于脑瘫致痉挛性马蹄内翻足治疗的方式有多种，包括物理治疗、矫形器治疗、全身性抗痉挛药物治疗、局部肌肉注射A型肉毒毒素以及各种外科手术治疗，针对不同的患儿畸形程度及年龄段，效果各有千秋。目的：探讨跟腱“Z”型延长胫骨前后肌联合肌腱转位移植修复脑瘫致痉挛性马蹄内翻足评价其改善外观，修复踝关节及足功能的作用。方法：于2012至2014年集中收治了22例脑瘫致痉挛性马蹄内翻足的患儿，均采用跟腱“Z”型延长胫骨前后肌联合肌腱转位手术方式进行治疗，术后行石膏外固定6周后，给予康复功能锻炼。结果与结论：22例患者均获得随访，随访平均时间为1至2年，依据秦泗河对足部畸形矫正程度及患者的满意程度进行评价，均获得满意疗效。结果表明，跟腱“Z”型延长胫骨前后肌联合肌腱转位治疗痉挛性脑瘫马蹄内翻足是治疗脑瘫致痉挛性马蹄内翻足的一种较好方法，具有良好的改善外观，踝关节及足的功能恢复良好的优点。
배경：국내대우뇌탄치경련성마제내번족치료적방식유다충，포괄물리치료、교형기치료、전신성항경련약물치료、국부기육주사A형육독독소이급각충외과수술치료，침대불동적환인기형정도급년령단，효과각유천추。목적：탐토근건“Z”형연장경골전후기연합기건전위이식수복뇌탄치경련성마제내번족평개기개선외관，수복과관절급족공능적작용。방법：우2012지2014년집중수치료22례뇌탄치경련성마제내번족적환인，균채용근건“Z”형연장경골전후기연합기건전위수술방식진행치료，술후행석고외고정6주후，급여강복공능단련。결과여결론：22례환자균획득수방，수방평균시간위1지2년，의거진사하대족부기형교정정도급환자적만의정도진행평개，균획득만의료효。결과표명，근건“Z”형연장경골전후기연합기건전위치료경련성뇌탄마제내번족시치료뇌탄치경련성마제내번족적일충교호방법，구유량호적개선외관，과관절급족적공능회복량호적우점。
BACKGROUND:It has a variety of treatments for equinovarus in spastic cerebral palsy, including physical therapy, orthotic therapy, systemic anti-spasticity drug therapy, local intramuscular injection of botulinum toxin type A and a variety of surgical operations. These treatments aim at different severity of deformities and different age in children patients, and each has its own merits. OBJECTIVE:To investigate the therapeutic effect of Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition to treat equinovarus in spastic cerebral palsy. METHODS: Twenty-two children with spastic cerebral palsy combined with equinovarus were colected from 2012 to 2014, and then these children were subject to Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition. Postoperative plaster external fixation was done for 6 weeks, and then rehabilitation training was given. RESULTS AND CONCLUSION:Al the 22 patients were folowed for an average of 1-2 years, and then were evaluated according to the degree of patient’s satisfaction and the degree of foot deformity. Satisfactory results were obtained from al the patients. Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition to treat spastic cerebral palsy combined with equinovarus is a good method, and it is characterized as good appearance of the ankle and favorable foot function.