Ilizarov踝关节弹性斜拉牵伸器在矫治重度马蹄足畸形中的应用

llizarov ankle elastic diagonal distraction to correct severe equinus

目的探讨Ilizarov踝关节弹性斜拉牵伸器在矫治重度马蹄足畸形中的应用价值。方法将2012年7月至2014年4月应用Ilizarov踝关节弹性斜拉牵伸器矫治的60例重度马蹄足畸形患者作为观察组，另选取2007年2月至2012年5月应用传统Ilizarov矫形器矫治的62例重度马蹄足畸形患者作为对照组，并进行回顾性研究。统计比较两组患者马蹄足矫形过程中距骨前脱位发生率、末次随访时Kofoed踝关节疼痛评分及美国足踝外科协会（AOFAS）的踝．后足评分。结果122例患者术后随访8．5-50．0个月，平均30．2个月。观察组矫形过程中距骨前脱位发生率（9．7％）低于对照组（0），末次随访时Kofoed踝关节疼痛评分（43．1±11．7）分和AOFAS的踝．后足评分（85．0±10．7）分均高于对照组（35．6±7．9）分和（70．3±14．2）分，差异有统计学意义（P〈0．05）。结论安装踝关节弹性斜拉牵伸器的Ilizarov矫形器在矫治重度马蹄足畸形可以有效预防矫形过程中距骨脱位并发症的发生，对于足踝关节功能的重建具有更可靠的疗效。

Objective To evaluate the Ilizarov ankle elastic diagonal distraction in correction of severe equinus. Methods The observation group included 60 patients with severe equinus who had been treated from July 2012 to April 2014 by Ilizarov ankle elastic diagonal distraction; the control group included 62 patients with severe equinus who had been treated from February 2007 to May 2012 by traditional Ilizarov equinus external fixation. The 2 groups were compared in terms of incidence of anterior dislocation of talus during the correction, Kofoed ankle pain score and American Orthopaedic Foot and Ankle Society （AOFAS） ankle-hindfoot score at the last follow-up. Results The 122 patients were followed up for a mean duration of 30.2 months （from 8.5 to 50.0 months）. The incidence of anterior dislocation of talus （9.7%）, Kofoed ankle pain score （43.1 ± 11.7） and AOFAS ankle-hindfoot score （85.0 ± 10. 7） in the observation group were all significantly higher than those in the control group （35.6 ± 7.9 and 70.3 ± 14.2, respectively） （ P 〈 0.05）. Conclusion Ilizarov ankle elastic diagonal distraction used to correct severe equinus can effectively prevent talar dislocation during correction, and facilitate reconstruction of the ankle function.