临床小儿外科杂志2016，Vol.15Issue(6)：535-539,5.DOI:10.3969/j.issn.1671-6353.2016.06.005
应用Ilizarov技术治疗儿童复发性僵硬型先天性马蹄内翻足
Treatment of recurrent rigid congenital clubfoot with Ilizarov technique
刘昆 1梅海波 1赫荣国 1唐进 1伍江雁 1张妮1
作者信息
- 1. 湖南省儿童医院骨科 湖南省长沙市，410007
- 折叠
摘要
Abstract
Objective To explore the clinical efficacy of llizarov technique in the treatment of recurrent rigid congenital clubfoot (CCF). Methods From January 2008 to December 201 5,Ilizarov technique was employed for treating 45 feet of 29 patients with recurrent rigid CCF.According to the Dimeglio classification, the clinical types wereⅢandⅣ.Through connections to tibia and calcaneus,metatarsal Ilizarov external fixa-tion ring could correct deformity gradually via four-dimensional adjustment (three-dimensional space plus one-dimensional time)so that normal foot shape and functionality were restored.The interventions included Ilizarov external fixator (31 feet),percutaneous Achilles tendon extension (9 feet),tarsal bone osteotomy (7 feet) and hind foot V-shaped osteotomy (3 feet).At Day 7 post-correction,the daily speed was 1 mm per day and it was completed 4 times.Ankle correction lasted until dorsal extension of around 1 0°and mild foot valgus.Or-thotopic fixation with external fixator or loaded walking for 4 weeks,short-leg cast plaster immobilized for 6 weeks after removing plaster cast and orthopedic worn for 3 years. Results The mean follow-up period was 39 (1 1 ~72)months.According to the International Society of clubfoot deformities (ICFSG)scoring system,the outcomes were excellent (23 feet),good (1 8 feet),decent (3 feet)and poor (1 foot,DimeglioⅣ).The ex-cellent rate was 91%.Early application of Ilizarov external fixation improved post-orthopedic gait.Calcaneal varus deformity persisted after 2 years.And it was cured by Triple Arthrodesis. Conclusions The application of llizarov external fixator is safe,mini-invasive and effective for three-dimensional correction of clubfoot de-formity.Especially is indicated for recurrent and rigid clubfoot of elder children.关键词
畸形足/外固定器/治疗/儿童Key words
Clubfoot/External Fixators/Therapy/Child引用本文复制引用
刘昆,梅海波,赫荣国,唐进,伍江雁,张妮..应用Ilizarov技术治疗儿童复发性僵硬型先天性马蹄内翻足[J].临床小儿外科杂志,2016,15(6):535-539,5.
