屈趾肌腱转位术对先天性马蹄内翻足动力平衡的疗效及影像学指标的影响

Therapeutic efficacy of flexor tendon transposition surgery on power imbalance of congenital clubfoot and its effect on imaging indexes

【目的】探讨屈趾肌腱转位术对先天性马蹄内翻足(congenital clubfoot,CCF)足踝平衡功能的疗效。【方法】选取CCF患者140例(225足)作为回顾性研究对象。依据分型随机分为2组:屈趾肌腱转位术组(A组112足)和胫后肌腱转位术组(B组113足)。分别行屈趾肌腱转位术和胫后肌腱转位术。术后随访2年,评估治疗效果。【结果】屈趾肌腱转位术组的Ⅲ级、Ⅳ级CCF的优良率高于胫后肌腱转位术,差异具有统计学意义(P<0.05)。屈趾肌腱转位术组Ⅲ级、Ⅳ级的术后CCF的Laaveg-Ponseti术前、后评分差值高于胫后肌腱转位术(P<0.05)。屈趾肌腱转位术组的Ⅲ级及Ⅳ级正位跟距角、侧位跟距角、距跖角及双踝角术后数值均优于胫后肌腱转位术(P<0.05)。【结论】屈趾肌腱转位术的临床疗效明显好于胫后肌腱转位术,能够改善患者足踝功能。

【Objective】To investigate the therapeutic efficacy of flexor tendon transposition surgery on ankle balance function of congenital clubfoot（CCF）.【Methods】A total of 140 cases with CCF（225 feet） were selected as the subjects in this retrospective study.According to the types, the patients were randomly divided into 2 groups： flexor tendon transposition surgery group（A group, 112 feet）and posterior tibial tendon transposition surgery group（B group, 113 feet）. They underwent the surgeries respectively and were followed up for 2 years. The therapeutic efficacy was evaluated.【Results】The excellent rate of grade Ⅲ and IV of CCF in A group was higher than that in B group. The difference was statistically significant between the two groups（P〈0.05）. The difference of Laaveg-Ponseti score before and after the surgery in A group was also higher than that in B group（P〈0.05）. The frontal Boehler＇s angle, lateral Boehler＇s angle and double ankle angle of grade Ⅲ and IV of CCF in A group were higher than those in B group after the surgery（P〈0.05）.【Conclusion】The clinical efficacy of flexor tendon transposition surgery is significantly better than that of posterior tibial tendon transposition surgery. It can improve the patients＇ ankle function.