早期手法矫正系列石膏固定治疗先天性马蹄内翻足

Ponseti procedure in early non-operative treatment for congenital talipes equinovarus

目的 评价早期应用手法矫正系列石膏固定 (Ponseti方法 )治疗先天性马蹄内翻足的效果。方法 从 1997年 5月～ 2 0 0 1年 12月保守治疗出生后 3个月内的先天性马蹄内翻足 2 2例共30个足。患儿的平均年龄为生后第 2 3d ,方法采用Ponseti的手法矫正和连续长腿石膏固定 ,每周更换石膏一次。在石膏固定结束后 ,患儿穿戴矫形支具至少 1年。结果 本组平均治疗时间 10 .5周 ,平均随访 2年 4个月。 2 7个足 (90 % )的畸形获得满意矫正 ,3个足因支具穿戴欠配合 ,随访时仍有残余畸形 ,需广泛软组织松解术矫正。结论 Ponseti的“旋后外展”手法矫正方法和连续长腿石膏固定 ,可使不同畸形程度的先天性马蹄内翻足在早期获得充分的矫正 ,石膏固定结束后应佩戴矫形支具至少 1年 ,以防畸形复发。

Objective To evaluative the efficacy of Ponseti procedure in the treatment for congenital clubfoot at the early stage of life. Methods From May 1997 to December 2001, 22 patients (30 feet)with congenital clubfoot who were consecutively treated within the first 3 months of life. The treatment was started on an average of 23 days after birth, and consisted of weekly manipulations and serial long leg casting for an average of 10.5 weeks, as described by Ponseti. When the last cast was removed, all children were fixed with brace for at least 1 year.Results The follow up results of 27 feet (90%) with a mean period of 2 years and 4 months were satisfactory except 3 cases of which didn't insist on the bracing with malformation relapsed and had to receive surgical operation.Conclusion The Ponseti procedure, supinating and abducting manipulation with serial long leg casting and succeed in brace fixing is effective to the various types of clubfeet at the early stage of life.