后内侧松解足背皮瓣旋转治疗马蹄内翻足

Treatment of Clubfoot by Posteromedial Release and Transposition of Pedal Dorsal Flap

为了提高先天性马蹄内翻足的治疗效果，减少其并有症和复发率，对手术法进行改进。经后内侧松解足背皮瓣旋转治疗先天性马蹄内翻足２１例（３５足），其中８例（１３足）行内侧韧带重建。手术年龄５个月～３岁。随访１８例（３２足），根据足外形、踝关节活动度、步态、行走时疼痛和Ｘ线表现，并参照Ｊｅｒｒｙ等评估方法进行疗效评定。结果优２６足（８１％），良５足（１６％），差１足（３％）。改进后的手术方法使足内侧软组织松解满意，可在无张力下缝合内侧切口，跗骨关节能完全复位，增加了足内侧稳定性，减少了远期并发症和降低了复发率。

Twenty-one cases (35 feet ) of congenital talipes equinovaurs were operated on by posteromedial release and transposition of pedal dorsal flap. Among them , 8 cases (13 feet ) received an additional medial ligament reconstruction. Their age ranged from 5 months to 3 years Eighteen cases (32 feet) were followed-up for three to nine years. According to the shape , ankle activity , gait , pain in walking and radiological findings of the foot , and comparison with the Jerry's criterion . the results were evaluated as follows , satisfactory in 26 feet (81%) , good in 5 (16%), and poor in 1(3%). The modified procedures consist with sufficient release of soft tissues . sutures under low tension , and complete reduction of the talocalcaneal , talonavicular and calcataecuboid joints . After operation , the medial stability of the foot increased and recurrence rate decreased.