三关节融合术治疗儿麻后遗马蹄内翻足远期效果综合分析

Comprehensive Analysis of Long-term Results of Polio-derived Equinovarus Treated with Triple Arthrodesis

目的 :综合评价三关节融合术治疗儿麻后遗马蹄内翻足的远期疗效。方法 :用临床标准和足底压力测定对术后 16年 3个月的 2 4名病人 2 4足进行了综合评定。结果 :临床效果优良 19足 ,可 5足 ;X线片显示 :三关节融合率、踝关节退行性变发生率 10 0 %。畸形复发为肢短造成的马蹄足复发。患足疼痛发生在踝关节及足底胼胝区 ,胼胝区压力明显大于对侧足相应区域 (P <0 .0 1)。临床疗效优良者 ,其动、静态足底压力较均匀。临床疗效可者足底压力异常。结论 :用临床标准和足底压力测定综合评定足部手术效果更为客观、准确。

Objective: To evaluate the long-term effects of polio-derived equinovarus treated with triple arthodesis by clinical standards combined with sloe pressure.Methods:Twenty-four patients(24feet) were followed-up for an average of 16 years and 3 months and the sole pressure distribution in feet(10 cases)were measured.Results:19 feet recovered with excellent or good outcome,5 fair or poor,x-ray postoperation showed that fusion rate of triple arthrodesis and degeneration rate in ankle joint is 100%,the deformity recurrence was mainly caused by shortness in the ill leg.The pain in ill foot is mostly in ankle joint and sole callus.Pressure in sole callus area is significantly higher than those in the other foot(P<0.01).In patients with excellent and good outcome,the sole pressure at rest and walking was distributed more equally.The sole pressure of the patients with poor outcome was distributed abnormally.Conclusion:It is more objective and accurate to evaluate the operation effect in foot by clinical standards combined with sole pressure analysis.