摘要
目的 分析先天性马蹄内翻足手术后复发的原因并提出预防措施。方法 对 66例 87足先天性马蹄内翻足首次手术后畸形复发的原因进行分析。结果 手术后复发的主要原因包括单纯软组织松解手术 (34足 )，转移肌肉发育差 (9足 )，肌力平衡术中解剖定位错误、转移肌腱附丽点选择不当 (27足 )，术后石膏松脱致附丽点脱落 (17足 )。结论 在彻底软组织松解、纠正畸形的同时，选择发育良好的肌肉、正确的肌腱附丽点位置 (第 3楔状骨为宜 )及合适的张力以建立有效的肌力平衡并注意加强术后石膏管理是预防手术后畸形复发的关键。术后定期复查，对术后复发病例早发现、早期正确手术处理，仍可取得较好疗效。
Objective To analyze the causes of the recurrence of congenital clubfoot post-operation in children and describe the prophylactic measures.Methods According to the clinical features and findings during reoperation,66 patients with 87feet were analyzed.Results Simple soft tissue release(34 feet), poor-developed transplanted muscle(9 feet), incorrect surgical technique,i .e.improper insertion or inadequte tension of the transplanted tendon(27feet),detachment of the tendon due to cast relaxing and displacement(17 feet),were the main causes of recurrence .Conclusion The prerequisites for better results are to release the soft tissue and correct the deformities to the full extent and achieve a dynamic balance of the muscles .A well-developed transplanted muscle with correct insertion(e.g.the third cuneiform bone)and appropriate tension,and careful plaster cast nursing are emphasized.The patients should be followed-up regularly.Cases with poor results from the initial operation should be found out and re-operated on in time so as to obtain a satisfactory outcome.
出处
《现代康复》
CSCD
2000年第11期1658-1659,共2页
Modern Rehabilitation
