分期Ilizarov技术肌腱转移矫正儿麻后遗重度足畸形
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中国人民解放军第三五九医院

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Staged Ilizarov technique for tendon transfer in the correction of severe foot deformity after poliomyelitis
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1.The 359th Hospital of the Chinese people'2.'3.s Liberation Army

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    摘要:

    [目的] 探讨分期Ilizarov技术肌腱转移治疗儿麻后遗症重度足下垂内翻畸形的临床疗效。[方法] 选择2012年6月至2018年6月我院24例儿麻后遗症重度足下垂内翻畸形病例资料,一期行跟腱延长联合Ilizarov技术矫正足下垂内翻畸形;待畸形矫正后,二期行胫后肌外移术维持软组织肌力平衡。[结果] 患者均获得随访,随访时间1-4年,平均2.58±0.80年。术后8个月和末次随访时,AOFAS踝-后足评分较术前显著升高,矢状面和冠状面胫足角较术前均明显减小,差异有统计学意义(P<0.001);踝关节退变分级(M-W)较术前有明显改善。术后有1例发生轻度针道感染;有1例发生转移肌腱松弛;所有病例未出现神经血管牵拉伤和畸形再次复发。[结论] 分期Ilizarov技术、胫后肌外移术治疗儿麻后遗症重度足下垂内翻畸形疗效确切,效果满意。

    Abstract:

    [Objective] To investigate the clinical effect of staging Ilizarov technique for tendon transfer in the treatment of severe foot valgus deformity caused by infantile anesthesia. [Methods] From June 2012 to June 2018, the data of 24 cases Of severe foot valgus deformity due to the sequelae of infantile anesthesia in our hospital were selected.At the first stage, Achilles tendon lengthening combined with Ilizarov technique was used to correct foot valgus; after the deformity was corrected, the posterior muscle was moved out to maintain the balance of soft tissue muscle strength. [Results] All patients were followed up for 1-4 years, with an average of 2.58±0.80 years. At 8 months after operation and the last follow-up, AOFAS ankle hindfoot score was significantly higher than that before operation, and the tibial foot angle in sagittal and coronal planes was significantly lower than that before operation (P < 0.001); The grade of ankle degeneration (M-W) was significantly improved compared with that before operation. One patient had mild needle infection after operation; There was 1 case of transfer tendon relaxation; There was no neurovascular injury or recurrence of malformation in all cases. [Conclution] Stage Ilizarov technique and posterior tibial muscle exodus are effective in the treatment of severe foot valgus deformity caused by infantile anesthesia. Key words: Ilizarov technology; Tend

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  • 收稿日期:2022-02-24
  • 最后修改日期:2022-06-28
  • 录用日期:2022-10-09
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