经皮针跟腱切断术治疗先天性马蹄内翻患儿疗效的研究

P. Madhuchandra, G. Sunilsanthosh, KP Raju
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摘要

简介:先天性马蹄足内翻(CTEV)是影响人类足部和踝关节最常见的畸形之一,Ponseti矫正法是普遍接受的手术方法。大多数患者需要经皮跟腱切断术治疗残留的马蹄骨畸形。使用白内障刀、11号刀片、21-G针等多种方法进行肌腱切断术。我们研究了经皮针跟腱切开术治疗CTEV儿童残留马蹄骨畸形的有效性。材料与方法:43例CTEV患者在我院行经皮针刺肌腱切断术,然后行石膏和矫形。超声检查证实了肌腱切开术和再生,动物尸体研究证实了完全的肌腱切开术。结果:所有患者均得到定期随访,平均随访2年,平均被动背屈25°。在我们的研究中没有发现皮肤瘢痕、神经血管损伤、僵硬或石膏并发症。结论:经皮针肌腱切开术治疗连续铸造CTEV患者残留马蹄骨畸形是一种简单、有效、安全的方法,可以获得功能和美容良好的跖足。
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Study on the effectiveness of percutaneous needle tendo Achilles tenotomy in congenital talipes equinovarus children
Introduction: Congenital talipes equinovarus (CTEV) is one of the most common deformities that affects the human foot and ankle, and Ponseti method of correction is universally accepted procedure. Most of the patients need a percutaneous tenotomy of tendo Achilles for residual equinus deformity. Various methods of tenotomy such as cataract knife, No. 11 blade, and 21-G needle are available. We studied the effectiveness of percutaneous needle tenotomy of the Achilles tendon in CTEV children for residual equinus deformity. Materials and Methods: Forty-three patients of serially manipulated and casted CTEV patients were subjected to a percutaneous needle tenotomy at our institute, followed by cast and orthosis. Tenotomy and regeneration were confirmed ultrasonologically and complete tenotomy was demonstrated by animal cadaver study. Results: All the patients were followed up regularly and an average of 25° of passive dorsiflexion was achieved at an average of 2-year follow-up. No cases of skin scarring, neurovascular compromise, stiffness, or cast complications were noted in our series. Conclusion: We conclude that percutaneous needle tenotomy for residual equinus deformity in a serially casted CTEV patient is a simple, effective, and safe method in giving a functionally and cosmetically good plantigrade foot.
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