Turco松解胫前肌外移治疗小儿先天性马蹄内翻足

摘要

One hundred and ninty feet of 130 cases of congenital talipes equinovarus treated by Turco's release and lateral transfer of anterior tibialis were reviewed.A follow up for 6 years in average revealed that in 94% of the cases the results were excellent and good based on Garceau's evaluation standard,and 6%recurrance.The correction of the maximum deformity was 40°plantarflexion in the ankle,45°of adduction in the forefoot and 30°of varus in the heel.The motion restored ranged from 15°～25°of dorsiflexion and 15°～30°plantarflexion in the ankle,and the angle formed between the long axis of food and the line connection medial and lateral malleoli increased from 400～70°,before operation,to 80°～90°after operation.The gait and shoes wearing of sick children almost resembled those of normal children.The authors think that one-stage release and transfer of anterior tibialis can give and maintain the structural and functional correction of the foot.The selective age for surgery ranges from 2 months to 1 years.Recurrence may be related to insufficient release,older cases at surgery and repeated operation.%用Turco松解胫前肌外移术治疗小儿先天性马蹄内翻足130例190足,平均随访6年.矫治最大度数:足跖屈畸形40°、前足内收45°、跟内翻30°,双踝联线与足底纵轴线夹角由40～70°恢复至80～90°,踝能背屈15～25°,跖屈15～30°.以Garceau评价标准评定疗效,总优良率94%,复发率6%.步态和鞋底磨损与正常儿童无明显差别.一次性彻底松解同时外移胫前肌,恢复了足的生物力学结构,能使患足恢复良好外形和功能.手术年龄以2个月至1岁为合适,复发与分次治疗、术中松解不够、患儿年龄偏大有关.