Ilizarov-Ponseti技术矫正马蹄内翻足畸形临床研究

Clinical study on Ilizarov-Ponseti methods for correction of talipes equinovarus

目的探讨Ilizarov技术与Ponseti程序结合矫正马蹄内翻足畸形的临床问题。方法回顾性复习了2016年5月—2019年9月,89例117个马蹄内翻足,安装自我改良的Ilizarov框架牵伸矫正。A组62足牵伸矫正程序非严格要求;B组55足为依照Ponseti程序牵伸矫正。总结矫正的过程及效果,对随访1年以上100足依据科室标准进行对比性研究。结果所有病例均完成治疗,A组:矫正时间17~51 d,平均31.5 d;带架时间41~73 d,平均53.3 d;合并距骨脱位13足。B组:矫正时间19~56 d,平均33.5 d;带架时间39~75 d,平均51.6 d;合并距骨脱位3足。100足随访1~5.5年,A组54足中,优11足,良26足,可12,差5足,优良率为68.5%;B组46足中优11足,良29足,可6足,差0足,优良率为87.0%。两组优良率比较,差异有统计学意义(χ^2=4.77,P﹤0.05)。结论应用Ilizarov技术结合Ponseti程序矫正马蹄内翻足畸形可以获得更好的疗效、并发症更少。

Objective To explore the clinical clinical efficacy of Ilizarov technique combined with Ponseti program in the correction of talipes equinovarus.Methods From May 2016 to September 2019,89 patients,117 feet of clubfoot were reviewed retrospectively.Ilizarov frame with self-improvement design was installed for all patients.In group A,62 feet were not strictly required in the draft correction procedure;in group B,55 feet were in accordance with Ponseti program.To sum up the process and effect of correction,a comparative study was conducted on 100 feet with a follow-up of more than one year.Results All patients completed the treatment,group A:the total correction time 17~51 days,average 31.5 days.The frame-loading time was 41~73 days,with an average of 53.3 days.In group B,the total correction time was 19~56 days,with an average of 33.5 days.The frame-loading time was 39~75 days,with an average of 51.6 days.3 feet with talus dislocation.100 feet were followed up for 1~5.5 years,54 feet in group A:excellent 11 feet,good 26 feet,fair 12 feet,poor 5 feet,excellent rate 68.5%;46 feet in group B:excellent 11 feet,good 29 feet,fair 6 feet,poor 0 feet,excellent rate 87.0%.The excellent rate was significant different between group A and group B(χ^2=4.77,P<0.05).Conclusion Ilizarov technique combined with Ponseti program can be used to correct talipes equinovarus to get better effect and fewer complications.