改良Ponseti法治疗儿童先天性马蹄内翻足疗效分析

目的评价改良Ponseti方法治疗儿童先天性马蹄内翻足的临床疗效。方法应用改良P0nseti方法治疗先天性马蹄内翻足15例（18足），平均年龄3．8岁。依据Dimeglio法分型和Pirani评分判定疗效。随访时间16-28个月，平均24个月。结果所有患儿均先行经皮跟腱切断后再行Ponseti石膏矫形。13例（16足）治愈，占88．89％；2例（2足）畸形明显，通过软组织松解并行胫骨前肌肌腱转移术治疗后获得矫正，平均治疗时间9．4周，全部患儿均在随访中。结论应用Ponseti方法治疗大龄儿童先天性马蹄内翻足由于畸形明显，先行跟腱切断后再行石膏矫形，效果满意。

Objective To explore the clinical effect of modified Ponseti methods for the treatment of older baby congenital clubfoot. Methods Fitteen patients （ 18 feet ） with congenital clubfoot, the ages of patients ranged from 3 years to 6 years old, average 3.8 years, were treated by modifying Ponseti method. Assessment effects according to Dimeglio methods and Pirani scores. The follow-up 16- 28 months, average 24 months. Results All patients were percutaneous tendoachilles tenotomy before manual correction and continuous casting orthopaedic. 16 feets were satisfied （ 88.89% ） , 2 feets with obvious deformity were satisfied with sott tissue solution and anterior tibial muscle. The duration of the treatment was 9.4 weeks in average, all the paitents were followinged up. Conclusion For the treatment of congenital clubfoot with obvious deformity in older baby. Modifying Ponseti methods, ie. percutaneous tendoachilles tenotomy before manual correction and continuous casting orthopaedic, has satisfactory curative effect.