程式化改良矫形重建术治疗中枢神经损伤后马蹄内翻足的临床研究

Clinical Study of Stylized Modified Orthotic Reconstruction for the Treatment of Clubfoot after Central Nerve Injury

目的:探讨程式化改良矫形重建术治疗中枢神经损伤后马蹄内翻足效果。方法:回顾我科2017年8月—2021年2月收治的10例(12足)马蹄内翻足患者临床资料,患者均采取程式化改良矫形重建术治疗,且术后给予患者早期康复治疗,患者均随访6~12个月,观察患者足部畸形矫正及并发症发生情况,并采取改良巴氏指数评分(MBI)进行ADL评分和国际马蹄足畸形研究会ICFSG评分系统对12足进行评估,观察患者疗效、治疗前后患者踝关节关节活动度(主动范围与被动范围)。结果:术后随访发现,患者患足畸形无复发,负重行走功能良好。较手术前,手术后12个月患者ICFSG评分及三项重要移动功能评分和MBI总分均显著改善,差异具有统计学意义(P<0.05);患者疗效观察,其中优8足,良3足,可1足,优良率91.7%,患者站立行走功能得到明显提高;治疗后,患者踝关节关节活动度明显提升(P<0.05)。结论:程式化改良矫形重建术治疗中枢神经损伤后马蹄内翻足效果显著,值得应用。

Objective:Discusses stylized improved orthopaedic reconstructive approach clubfoot effect after treatment of central nervous system injury.Methods:The clinical data of 10 patients with varus equinus(12 feet) admitted to our department from August 2017 to February 2021 were reviewed.All patients were treated with stylized modified orthopedic reconstruction, and were given early rehabilitation treatment after surgery.Patients were followed up for 6~12 months to observe the occurrence of foot deformity correction and complications.The 12 feet were evaluated by ADL score with modified Pap index score(MBI) and ICFSG score system of international society for horseshoe and foot deformity study, and the therapeutic effect and ankle range of motion(active range and passive range) before and after treatment were observed.Results:Postoperative follow-up showed that the patient had no recurrence of foot deformity and good weight-bearing walking function. Compared with before surgery, ICFSG score, three important mobile function score and total MBI score were significantly improved 12 months after surgery, the difference was statistically significant(P<0.05).The patients’ curative effect was observed, among which 8 were excellent, 3 were good, and 1 was fair, with a excellent and good rate of 91.7%.The patients’ standing and walking function was improved significantly.After treatment, the range of motion of ankle joint was significantly improved(P<0.05).Conclusion:Programmed modified orthopedic reconstruction is effective in the treatment of clubfoot after central nerve injury, which is worthy of application.