CAJ | 학술논문

两种方法治疗儿童僵硬性马蹄内翻足的中期效果评价
량충방법치료인동강경성마제내번족적중기효과평개
Mid-term result of two techniques in management of congenital rigid clubfoot in children

万方数据

临床小儿外科杂志臨床小兒外科雜誌 림상소인외과잡지
JOURNAL OF CLINICAL FEDIATRIC SURGERY
2015年 2期 110-112,120 ,共4页

朱光辉%梅海波%赫荣国%刘昆%唐进%伍江雁%叶卫华%胡欣%谭谦%严安%黄生祥%谭晓谦%雷霆%张妮

주광휘%매해파%혁영국%류곤%당진%오강안%협위화%호흔%담겸%엄안%황생상%담효겸%뢰정%장니

畸形足%外科手术/方法%评价研究%儿童畸形足%外科手術/方法%評價研究%兒童
기형족%외과수술/방법%평개연구%인동
Clubfoot%Surgical Procedures,Operative /MT%Evaluation Studies%Child

目的：评价 Ponseti 方法和足后内侧软组织松解手术治疗儿童僵硬性马蹄内翻足的中期效果。方法对本院2005年4月至2010年6月收治的僵硬性马蹄内翻足病例资料进行回顾性研究。按照治疗方法的不同，分为 Ponseti 方法组和足后内侧软组织松解手术组。按 Pirani 系统进行评分。术后使用 Laaveg 和 Ponseti 功能评分系统（FRS）进行效果评价。结果共43例（55足）纳入研究，23例（28足）采用 Ponseti 方法治疗，随访时间50～82个月，平均67个月。20例（27足）采用后内侧软组织松解术治疗，随访时间56～90个月，平均75个月。治疗开始时两组 Pirani 评分之间无显著差异（P ＞0．05）。两组治疗前后 Pirani 评分显著减小（P ＜0．05）。Ponseti 方法组有更高的 FRS 评分（P ＜0．01）。Ponseti 方法组的最大被动背伸活动度评分更高（P ＜0．01）。两组影像学结果相似。但 Ponseti 方法组的复发率较软组织松解手术组的复发率低。结论与后内侧软组织松解术相比，Ponseti 方法治疗儿童僵硬性马蹄内翻足的中期效果更好。
목적：평개 Ponseti 방법화족후내측연조직송해수술치료인동강경성마제내번족적중기효과。방법대본원2005년4월지2010년6월수치적강경성마제내번족병례자료진행회고성연구。안조치료방법적불동，분위 Ponseti 방법조화족후내측연조직송해수술조。안 Pirani 계통진행평분。술후사용 Laaveg 화 Ponseti 공능평분계통（FRS）진행효과평개。결과공43례（55족）납입연구，23례（28족）채용 Ponseti 방법치료，수방시간50～82개월，평균67개월。20례（27족）채용후내측연조직송해술치료，수방시간56～90개월，평균75개월。치료개시시량조 Pirani 평분지간무현저차이（P ＞0．05）。량조치료전후 Pirani 평분현저감소（P ＜0．05）。Ponseti 방법조유경고적 FRS 평분（P ＜0．01）。Ponseti 방법조적최대피동배신활동도평분경고（P ＜0．01）。량조영상학결과상사。단 Ponseti 방법조적복발솔교연조직송해수술조적복발솔저。결론여후내측연조직송해술상비，Ponseti 방법치료인동강경성마제내번족적중기효과경호。
Objective To evaluate the middle-term outcome of Ponseti method and posteromedial re-lease in management of congenital rigid clubfoot in children. Methods A retrospective control study on the patients with congenital rigid clubfoot admitted was conducted during April,2005 to June,2010.The cases were divided into 2 groups by the different technique:Ponseti method and posteromedial release group.the patients were scored by Pirani score system.the Function Rating System (FRS)of Laaveg and Ponseti were used to as-sess the outcome. Results There were 43 cases (55 feet)enrolled in our study.23 cases (28 feet)were treated by Ponseti method with a mean follow up of 67 months (range,50 ~82 months)while 20cases (27 feet)were managed by posteromedial release with a mean follow up of 75 months (range,56 ~90 months).Pi-rani Scores showed no significant differences at the beginning of treatment (P >0.05).But pre-op and post-op Pirani Scores in both groups decreased significantly (P <0.05).The FRS total score in the Ponseti group was higher than the posteromedial release group (P <0.01).Passive maximal dorsiflexion scored higher in Ponseti group.The radiographic variables were similar between the groups.Recurrence rate of Ponseti group was lower than the posteromedial release group. Conclusions Compared with posteromedial release,Ponseti method has a favorable mid-term outcome in management of congenital rigid clubfoot in children.