早期肌力平衡手术治疗先天性马蹄内翻足的远期疗效

摘要

报告并评价早期肌力平衡手术治疗先天性马蹄内翻足的远期疗效.1957～1994年采用早期矫正畸形建立肌力平衡手术治疗3个月～12岁儿童先天性马蹄内翻足1 088例1 521足.采用自行制定的疗效评定标准,对术后6～36年(平均11年6个月)、随访时年龄13～40岁的128例188足(其中年龄在18岁以上52例74足)的远期疗效进行评价.总优良率89.4%,骨骼完全成熟患儿的优良率89.2%.手术疗效与足踝部主要肌肉功能、术前足畸形程度和手术时年龄均有明显关系(P＜0.05).手术操作不当也可影响手术疗效.早期矫正畸形并建立动态肌力平衡手术是治疗儿童先天性马蹄内翻足的有效方法,能取得外观及功能满意的远期疗效.%To introduce and evaluam the long-term results of early operation to make muscle dynamic balance in the treatment of congenital clubfoot,1088 patients aged 3 months to 12 years with congenital clubfoot(1521 feet)were treated by early operations from 1957 to 1994.Long-term results of 128 patients (188 feet)were evaluated according to the criteria made by the authors.The follow-up period ranged from 6 to 36 years(11 years and 6 months on average).The ages at the last follow-up ranged 13 to 40 yrs,Among them,52 cases(72 feet)were older than 18 years.The results are excellent and good in 89.4% of the total.Definite relationship was found among the efficacy and preoperative function of muscles,the sererity of the deformity,and the age at operation(P＜0.05).An improper technique might affect the final outcome.Early correction of deformities to restore muscle dynamic balance is an effective method to achieve sa tisfactory long-term results in function and appearance of congenital clubfoot.