Ilizarov技术矫正儿童僵硬型马蹄内翻足畸形

摘要

Objective To explore the outcome of Ilizarov technique in treatment of the rigid talipes equinovarus deformity in children.Method The Ilizarov technique was used in 6 patients (8 feet) with the rigid talipes equinovarus deformity in children.Among these patients, 2 cases were congenital, 1 by trauma, 1 by complication from encephalitic paralysis, 1 by the poliomyelitis and 1 by ankle and foot deformities secondary to oschemic contracture of the leg.According to the principles of Ilizarov, Ilizarov external fixators was placed in relative position of the foot and leg during operation.The telescopic rods on the apparatus were rotated one week after the operation.The deformity of talipes quinovarus, internal rotation and the drooping of the forefoot were gradually corrected and walked on the deformity foot during the course of distractive correction.Results All of the 6 patients were followed up for 2 months to 16 months with an average of 11 months.All of deformities in the feet were corrected satisfactorily, full feet contacted with the ground in stand or walking and achieved with good function and there was no recurrence of the deformity.Prospective goals of correction were made in all the cases.For 6 patients (8 feet), 6 feet achieved excellent result and 2 feet good.Conclusion Ilizarov technique for treatment of the rigid talipes equinovarus deformity is minimally invasive, simple and safe method.%目的 探讨应用Ilizarov技术矫正儿童僵硬型马蹄内翻足畸形的方法和疗效.方法 应用Ilizarov外固定矫形器治疗儿童僵硬型马蹄内翻足畸形6例8足.术中遵循Ilizarov穿针固定的基本原则,将组装好的Ilizarov外固定器安装在患侧小腿和足部的相应位置.术后7天开始旋转相应的螺纹牵伸杆,逐渐矫正足内翻、内收和下垂畸形并适当过牵,使畸形得到良好矫正.在牵伸矫形过程中行患足负重行走.结果 6例患者术后均获得随访,随访时间2～16个月,平均11个月.畸形足均获得满意矫正和足底持重、行走功能良好,畸形未复发.按Garceau标准评定疗效,优6足,良2足.结论 Ilizarov技术矫正僵硬型马蹄内翻足畸形效果良好,具有微创、操作简单、安全并能早期活动的优点,值得临床推广应用.