Turco松解胫前肌外移治疗小儿先天性马蹄内翻足

Treatment of Congenital Talipes Equinovarus in Children by Turco's Release and Anterior Tibial Transfer

用Ｔｕｒｃｏ松解胫前肌外移术治疗小儿先天性马蹄内翻足１３０例１９０足，平均随访６年。矫治最大度数：足跖屈畸形４０°、前足内收４５°、跟内翻３０°，双踝联线与足底纵轴线夹角由４０～７０°恢复至８０～９０°，踝能背屈１５～２５°，跖屈１５～３０°。以Ｇａｒｃｅａｕ评价标难评定疗效，总优良率９４％，复发率６％。步态和鞋底磨损与正常儿童无明显差别。一次性彻底松解同时外移胫前肌，恢复了足的生物力学结构，能使患足恢复良好外形和功能。手术年龄以２个月至１岁为合适，复发与分次治疗、术中松解不够、患儿年龄偏大有关。

One hundred and ninty feet of 130 cases of congenital talipes equinovarus treated by Turco's release and lateral transfer of anterior tibialis were reviewed.A follow up for 6 years in average revealed that in 94% of the eases the results were excellent and good based on Garceau's evaluation standard,and 6% recurrance.The correction of the maximum deformity was 40°planlarflexion in the ankle.45°of adduction in the forefoot and 30°of varus in the heel.The motion restored ranged from,15°～25°of dorsiflexion and 15°～30°plantarflexion in the ankle.and the angle formed between the long axis of food and the line connection medial and lateral malleoli increased from 40°～70°,before operation,to 80°～ 90°,after operation.The gait and shoes wearing of sick children almost resembled those of normal children.The authors think that one-stage release and transfer of anterior tibialis can give and maintain the structural and functional correction of the foot.The selective age for surgery ranges from 2months to 1 years. Recurrence may be related to insufficient release,older cases at surgery and repeated operation.