Ponseti石膏矫形法治疗汉族和维吾尔族先天性马蹄内翻足效果分析

目的评价应用Ponseti石膏矫形疗法治疗汉族和维吾尔族儿童先天性马蹄内翻足（CCF）的疗效，并在新疆推广该方法。方法2009年6月至2013年6月，上海交通大学附属儿童医院骨科收治汉族CCF婴幼儿68例（98足），其中男45例（62足），女23例（36足），年龄10天～13个月（第一组）；2013年1月至10月，新疆喀什地区第二人民医院骨科收治维吾尔族CCF婴幼儿及儿童29例（44足），其中男18例（26足），女11例（18足），年龄7天～27个月，选取其中大于12个月患JL（13~27个月）24例（36足）为第二组。全部病例均接受Ponseti疗法治疗，其中汉族患儿每2周更换石膏固定，维吾尔族患儿每周更换石膏固定。根据Dimeglio分类和功能评价方法评估治疗效果。结果所有病例均获随访3～40个月（平均12±3个月）。根据Dimeglio分类和功能评价方法评估，92例中90例（132足）矫形效果满意，评分达到I级。两组间治疗优良率差异无显著意义（P〉0．05）。每组分别有1例1足残留有轻度前足内收畸形，需进一步治疗。结论Ponseti疗法治疗维吾尔族患儿与汉族患儿CCF可取得同样确切的疗效。只要治疗方法规范，石膏更换频率、30个月龄内起始治疗对疗效无明显影响，均可取得满意疗效。

Efficacy analysis of Ponseti method for congenital clubfoot in Han and Uyghur population

Objective To evaluate the effect of Ponseti method in treatment of congenital clubfoot （CCF） patients in Han and Uyghur population, and popularize this treatment in Xinjiang of China. Methods From June 2009 to June 2013, 68 Han patients （98 feet） aged from 10 days to 13 months with CCF, including 45 males （62 feet）, 23 females （36 feet）, were treated in Shanghai Children＇s Hospital （group l）. And 24 Uyghur patients （36 feet） aged from 13 to 27 months with （Y.2F, including 18 males （26 feet）, 6 females （9 feet） , were treated in Kashi Second People＇s Hospital （group 2）. Each patient was managed by Ponseti method. According to the frequency of changing plastic cast, the casts of the Han eases were changed every 2 weeks and that of the Uyghur cases were changed every week. The deformation degree of CCF was evaluated by Dimeglio classification scoring system before and after treatment. Results All patients were followed up from 3 to 40 months, average I2 ＋ 3 months. According to the Dimeglio classification scoring system, there were 90 cases （132 feet） classified as satisfying （reach grade I ）. The excellent rate showed no significant differences between the 2 groups （P〉0. 05）. Two cases with 2 feet remained residual deformity. Conclusions Ponseti method is an excellent method in CCF treatment, its therapeutic effect is satisfying in Uyghnr population as same as in Han population. Using Ponseti method can achieve excellent results in CCF patients within 30 months old.