先天性马蹄内翻足早期肌力平衡手术中期及远期疗效对比分析

目的 研究早期采用肌力平衡手术对治疗先天性马蹄内翻足术后中期及远期的疗效对比及原因分析.方法 1957至1993年,采用早期肌力平衡手术治疗CCF970例1 373足(手术年龄平均1岁),采用自行设计的评定标准,对术后16～52年(平均22年6个月)的470例569足进行随访.结果 此次远期随访总优良率为82.07%,较1999年的中期随访总优良率91.83%有明显下降(P<0.05).术后远期疗效与术前畸形程度和手术年龄有明显相关性,术前轻度畸形术后远期优良率与中度和重度畸形优良率差异有统计学意义(P<0.05),主要原因为术前中重度畸形患儿术后远期优良率明显下降.手术年龄为6个月至1岁的患儿术后远期优良率89.34%,均高于其他年龄组,差异有统计学意义(P<0.05),与中期随访结果 一致.结论 采用早期肌力平衡手术纠正先天性马蹄内翻畸形远期效果优良,术后远期优良率较中期降低,可指导l临床早期制定更为全面的手术方案.

Evaluation of the long- and mid-term outcomes of surgical treatment of congenital clubfoot treatment

Objective To evaluate the long- and mid-term outcomes of surgical treatment of congenital clubfoot treatment. Methods From 1957 to 1993,1373 congenital clubfeet of 970 patients age age of 1 year. The long-term results of 470 patients (569 feet) were evaluated using self-designed criteria. The follow-up period ranged from 16 to 52 years (mean,22 years and 6 months). Results Good and excellent results were achieved in 82. 07% patients after long term follow-up. The long term outcomes were correlated with the severity of the deformity and the age at operation (P<0.05). The good and excellent outcomes after mid-term follow-up were 91.83%. The long term outcomes of the patients with mild malformations were significantly better than those with moderate or severe malformations (P<0.05). The patients aged 6 months to 1 year old achieved better long term outcomes than other groups (P<0.05). Conclusions Good long term outcomes can be achieved by performing corrective operations in early age in the children with congenital clubfoot treatment.