早期肌力平衡手术治疗先天性马蹄内翻足的远期疗效

报告并评价早期肌力平衡手术治疗先天性马蹄内翻足的远期疗效。１９５７～１９９４年采用早期矫正畸形建立肌力平衡手术治疗３个月～１２岁儿童先天性马蹄内翻足１０８８例１５２１足。采用自行制定的疗效评定标准，对术后６～３６年（平均１１年６个月）、随访时年龄１３～４０岁的１２８例１８８足（其中年龄在１８岁以上５２例７４足）的远期疗效进行评价。总优良率８９．４％，骨骼完全成熟患儿的优良率８９．２％。手术疗效与足踝部主要肌肉功能、术前足畸形程度和手术时年龄均有明显关系（Ｐ＜０．０５）。手术操作不当也可影响手术疗效。早期矫正畸形并建立动态肌力平衡手术是治疗儿童先天性马蹄内翻足的有效方法，能取得外观及功能满意的远期疗效。

Long-term Results of Early operation to Make Muscle Dynamic Balance on Congenital Clubfoot

To introduce and evaluate the long-term results of early operation to make muscle dynamic balance in the treatment of congenital clubfoot,1088 patients aged 3 months to 12 years with congenital clubfoot(1521 feet)were treated by early operations from 1957 to 1994. Long-term results of 128 patients(188 feet)were evaluated according to the criteria made by the authors.The follow-up period ranged from 6 to 36 years(11 years and 6 months on average).The ages at the last follow-up ranged 13 to 40 yrs,Among them,52 eases(72 feet)were older than 18 years.The results are excellent and good in 89.4% of the total.Definite relationship was found among the efficacy and preoperative function of muscles,the severity of the deformity,and the age at operation(P<0.05).An improper technique might affect the final outcome.Early correction of deformities,to restore muscle dynamic balance is an effective method to achieve sa tisfactory long-term results in function and appearance of congenital clubfoot.