临床小儿外科杂志2020，Vol.19Issue(9)：779-784,6.DOI:10.3969/j.issn.1671—6353.2020.09.004
经皮跟腱切断治疗马蹄内翻足的术中疗效观察
Intraoperative observations of tenotomic efficacy for pediatric clubfoot
杨征 1鲁明 1高雷 1张宇辰 1钱驭涛 1闫桂森1
作者信息
- 1. 北京积水潭医院小儿骨科 北京市,100035
- 折叠
摘要
Abstract
Objective Currently Ponseti method is a standard treatment for low-age children with talipes equinus. Deformity is mostly corrected through plaster casting and tenotomy and tenotomy of Achilles tendon (TAT) is focused upon plantar flexion. Our study was intended to clarify the corrective capacity of this operation and discuss its effective range (ER) by comparing different monthly ages and varying degrees of deformity. Methods Clinical data were collected for all cases of congenital talipes equinus undergoing tenotomy over the last two years. Patient profiles and related intraoperative data were collected. Two grouping methods were employed used for comparison. Based upon monthly age, the authors observed whether or not there was a correlation between different operative ages and ER and analyze the changing trend of ER with a higher age. Then according to severity of original deformity, whether or not there was a difference in corrective efficacy. Results A total of 173 children fulfilled the inclusion criteria. The operative sideness was bilateral (n=68) and unilateral (n=105). A total of 241 cases of percutaneous Achilles tenotomy were performed. One-way ANOVA was employed for comparing the differences among 9 monthly age groups (F=9.187, P<0.001). Statistical difference existed in perative ER among different groups. Through LSD multiple comparison, there was less variation between 3 to 6 months. However, statistical differences existed among other groups. By data analysis，early treatment yielded better outcomes. For the same operation, low-age children could obtain larger corrective ER. According to the degree of severity, the cases was classified by Pirani score (6 sub-system):≥5 severe while＜5 mild. The results of independent-samples T test were as follows: t value 0.395，p value 0.693 and p value>0.05. The severity of original deformity did not affect the value of operative ER. The ER of tenotomy was 35.32 ±8.283 degrees. Conclusion At approximately 35 degrees，ER of TAT is closely correlated with monthly age. Operative ER decreases with a higher monthly age while corrective capacity of TAT has nothing to do with the severity degree of original deformity.关键词
马蹄足畸形/外科学/跟腱/外科学/外科手术/方法/治疗结果/儿童Key words
Equinus Deformity/SU/Achilles Tendon/SU/Surgical Procedures/Operative/MT/Treatment Outcome/Child分类
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杨征,鲁明,高雷,张宇辰,钱驭涛,闫桂森..经皮跟腱切断治疗马蹄内翻足的术中疗效观察[J].临床小儿外科杂志,2020,19(9):779-784,6.
