摘要
目的通过评估术后形态及功能结果,对比Ilizarov外固定架矫正术与跟腱延长术治疗儿童马蹄内翻足的疗效。方法回顾性分析2016年1月至2020年12月郑州大学第一附属医院小儿外科收治的马蹄内翻足患儿的临床及随访资料,按照手术方式分为观察组(Ilizarov外固定架治疗)27例(37足)、对照组(跟腱延长术治疗)28例(34足)。应用Diméglio评分方法进行形态学评估、Laaveg-Ponseti评分方法进行功能学评估,比较两组患儿治疗前后的形态及功能结果;比较两组患儿治疗中并发症发生情况及治疗后复发情况。结果随访15~73个月,末次随访时,两组Diméglio评分均低于治疗前,差异具有统计学意义(P<0.05);两组Laaveg-Ponseti评分均高于治疗前,差异具有统计学意义(P<0.05)。末次随访时观察组年龄与Laaveg-Ponseti分级无显著相关性(P>0.05),对照组年龄与Laaveg-Ponseti分级呈正相关(P<0.05)。随访期间观察组并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。观察组复发率低于对照组,但差异无统计学意义(P>0.05)。结论Ilizarov外固定架技术作为一种微创的渐进式畸形矫正方法,治疗儿童马蹄内翻足所取得的形态和功能结果优于跟腱延长术,并能有效减少并发症的发生,更适用于年龄较大患儿的治疗。
Objective To evaluate the effects of Ilizarov external fixator and Achilles tendon lengthening in the treatment of congenital equinovarus based on the analysis of the postoperative morphological and functional results.Methods The clinical and follow-up data of children talipes equinovarus treated in the pediatric surgery of the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2020 were retrospectively analyzed.According to surgical methods,they were divided into observation group(treated with Ilizarov external fixation frame)27 cases(37 feet)and control group(treated with Achilles tendon lengthening)28 cases(34 feet).The results were evaluated morphologically by Diméglio score and functionally by Laaveg-Ponseti rating scale.The morphological and functional results before and after treatment were compared between the two groups.The complications during treatment and recurrence after treatment were compared between the two groups.Results The follow-up was 15-73 months.At the final follow-up,the Diméglio scores in both groups were lower than before treatment,and the difference was statistically significant(P<0.05).The Laaveg-Ponseti scores in both groups were higher than before treatment,and the difference was statistically significant(P<0.05).There was no significant correlation between age and Laaveg-Ponseti classification in the observation group at the final follow-up(P>0.05),while there was positively correlation between age and Laaveg-Ponseti classification in the control group(P<0.05).The total incidence of complications in observation group was lower than in control group during the follow-up period(P<0.05).The recurrence rate in observation group was lower than in control group,but there was no statistical significant difference(P>0.05).Conclusion As a minimally invasive method of gradual deformity correction,Ilizarov external fixator technique can achieve better morphological and functional results than Achilles tendon lengthening in the treatment of children with talipes e
作者
严敦
刘秋亮
秦攀
赵伟
周迪鸣
员夏飞
韩亚辉
张蛟
YAN Dun;LIU Qiuliang;QIN Pan;ZHAO Wei;ZHOU Diming;YUAN Xiafei;HAN Yahui;ZHANG Jiao(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2023年第4期621-625,共5页
Henan Medical Research
关键词
马蹄内翻足
ILIZAROV外固定架
微创手术
跟腱延长术
talipes equinovarus
Ilizarov external fixator
minimally invasive surgery
Achilles tendon lengthening
