胫神经肌支切断术治疗脑瘫痉挛性马蹄内翻足

目的：评价胫神经肌支切断术治疗脑瘫痉挛性马蹄内翻足的疗效。方法：52例痉挛型脑瘫SPR术后马蹄内翻足畸形患者,男33例（38足）,女19例（26足）;年龄6～10岁,平均7.8岁。Ashworsh分级：Ⅲ级34例,Ⅳ级18例;踝阵挛阳性者42例。采用胫神经肌支切断术治疗。结果：随访1～3年,平均2.6年,痉挛步态明显改善,畸形均无复发。根据足部畸形矫正程度及患者的满意程度进行综合判定：优32例,良14例,差6例。结论：胫神经肌支切断术治疗小儿脑瘫痉挛性马蹄内翻足是一种安全、有效的手术方法。

Treatment of equinovarus caused by cerebral palsy with neurotomy of muscular branch of tibial nerve

Objective：To evaluate clinical effect of neurotomy of muscular branch of tibial nerve for the treatment of equinovarus caused by cerebral palsy. Methods： Fifty-two cases of equinovarus caused by cerebral palsy were treated with neurotomy of muscular branch of tibial nerve. The male was 33 （38 feet） and the female 19 （26 feet） with the average age of 7.8 years old （from 6 to 10）. The muscular tension according to Ashworsh grade,34 cases were grade Ⅲ and 18 cases were grade IV. The ankle clonus was positive in 42 cases. Results： All cases were followed up for 1-3 years with the average of 2.6 years. The spastic gait of cases had obviously improved and abnormity had no recurred. According to corrective degree of abnormity and satisfactive condition of patients, evaluation of the effect were excellent in 32 cases, good in 14, poor in 6. Conclusion： Neurotomy of muscular branch of tibial nerve is the safe and effective method for the treatment of equinovarus caused by cerebral palsy.