先天性多发关节挛缩症致马蹄内翻足的治疗

Surgical treatment of talipes equinovarus in arthrogryposis multiplex congenita

目的 研究先天性多发关节挛缩症患者的马蹄内翻足畸形治疗。 方法 回顾性分析先天性多发关节挛缩症的马蹄内翻足畸形 32例 (6 4足 )的临床资料 ,根据Sodergard评定方法进行综合评价。 结果 保守治疗满意 4足。手术治疗 6 0足中 ,14足 1次手术获得满意结果 ,46足初次术后畸形复发 ,占 77 7% ,有些足需 3次手术。 结论 手术治疗应在 1岁前行彻底的软组织松解 ,对于复发性。

Objective[WT5”BZ] To study the treatment of talipes equinovarus in arthrogryposis multiplex congenita(AMC). [WT5”HZ]Methods[WT5”BZ] We retrospectively reviewed 64 feet deformities in 32 patients with AMC who were treated from 1980 to 1998 and evaluated according to the Sodergard grading. [WT5”HZ]Results[WT5”BZ] Conservative treatment was considered satisfactory in 4 feet, 60 feet were operative. Recurrence of the deformity occurred in 46 feet (77 7%), which underwent third operation. Despite a high recurrence rate, 14 feet were treated first with radical soft tissue release or talectomy. [WT5”HZ]Conclusions[WT5”BZ] Clubfoot deformity in arthrogrypotic patients can be treated first with radical soft tissue when the patient is less than 1 year of age. If the foot deformity is persistent or recurs, more radical operative methods (e.g.,talectomy)are advocated. [WT5”HZ]