目的评估分期治疗僵硬性高弓马蹄内翻畸形的疗效。方法2010年12月至2013年12月，采用分期策略治疗26例僵硬性高弓马蹄内翻畸形，其中男性15例，女性11例，平均年龄42．8岁（35～66岁）。所有患者均行一期经皮跟腱延长术及环形支架矫正，待力线纠正后行二期距周关节融合术。结果22例获得随访，平均随访30个月（12～48个月）。平均骨性愈合时间为12周（10～15周）。末期随访时美国足踝骨科学会（AOFAS）踝‐后足评分及疼痛视觉模拟评分（VAS）均较术前明显改善（P＜0．05），除2例患者出现伤口浅部感染（经换药后愈合）外，其余患者伤口均一期愈合。随访期间未见融合失败、畸形愈合或复发、固定失效、医源性血管神经损伤等并发症。结论分期策略是僵硬性高弓马蹄内翻畸形安全可靠的治疗方案，可有效纠正力线，避免软组织并发症，降低二次手术难度。%Objective To evaluate the clinical outcome of staged strategy for rigid cavus eqiunovarus deformity .Methods From December 2010 to December 2013 ,26 cases of rigid cavus equinovarus deformity were treated .There were 15 males and 11 females with an average age of 42 .8 years (range ,35‐66 years) .All patients underwent the first stage of close achilles tendon lengthening and Illizarov fixator correction ,while the second stage of pan‐talar arthrodesis was performed when the realignment was achieved . Results Twenty‐two patients got an average 30 months follow‐up (range ,12‐48 months) .Average time of bone union was 12 weeks (range ,10‐15 weeks) postoperatively .The American Orthopedic Foot and Ankle Society (AOFAS) ankle and hind‐foot score and Visual Analogue Scale (VAS) score improved significantly at the final follow‐up .Superficial infection occurred in 2 patients ,which was cured uneventfully by dress changing .There was no complications of fusion failure ,deformity recurrence ,malunion ,implant failure ,and iatrogenic neuro‐vascular injury .Conclusion Staged strategy for rigid cavus equinovaurs deformity was proved to be a safe and effective technique ,which can achieve the realignment ,avoid soft tissue complications ,and facilitate the second stage operation .
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