改良Mckay术治疗小儿僵硬型先天性马蹄内翻足

Modified Mckay Procedure For Treatment of Rigidity Congenital Clubfoot in Children

目的探讨改良Mckay术治疗小儿僵硬型先天性马蹄内翻足(CCF)的临床应用及近期疗效。方法2003年～2005年采用改良Mckay术治疗小儿僵硬型先天性马蹄内翻足36例(共54足),术中采用跟腱外侧弧形切口或直切口,加大后侧松解范围,充分延长跟腱和屈拇长肌腱,将胫前肌腱部分切断,以克氏针固定于距下关节,术后石膏固定6～8周。结果均痊愈,平均随访2.3年(1～3年),根据术后足的外观形态、足印、踝部功能、有无疼痛及X线检查评价疗效,疗效优25例38足;良8例12足;可3例4足,优良率为92.59%。结论改良Mckay术是矫正小儿僵硬型先天性马蹄内翻足的有效手术方法,其优点是损伤小、手术时间短,矫形效果良好。

Objective To improving Mckay operation mode in treatment of congenital clubfoot(CCF)and investigate its feasibility and explore in the near future efficacy.Methods 36 cases(54 feet)of regidity congenital clubfoot patients from 2003 to 2005 in our hospital were treated surgically with modified Mckay operation.We used arc incision or straight incision at lateral heel tendon expended lysis range at posterior talaral,full prolonged heel tendon and flexor pollicis longus tendo,partial amputated the anterior fibial tendon talocrual joint was fixed by kirschner wire which were carried out in the operative period plaster fixation for 6-8 weeks.Results All the patients were followed up for 1-2 years,average 1.7 years.The surgical therapeutic results were evaluated with external appearance feet blotting,podogram,ankle function and X-ray check,with excellent 25 cases in 38 feet,good 8 cases in 12 feet and satisfaction 3 cases in 4 feet.Excellent results were achieved in 92.59% of cases.Conclusions Modified Mckay operation is effective surgical mode,as compare with classic Mckay operation its merits are less injury,spend short time of operation,but can get a good orthopedic outcome,wound healing well,and rapid recovery.