Carroll手术治疗儿童先天性马蹄内翻足

目的 探讨Carroll手术治疗儿童先天性马蹄内翻足(congenital clubfoot,CCF)的疗效和影响疗效的可能性因素.方法 采用Carroll手术原理和方法对268例Dimeglio分型Ⅲ、Ⅳ型的先天性马蹄内翻足实施治疗,其中男200例(230足),女68例(78足),单侧228例,双侧40例,共308足;手术年龄为6个月～10岁,平均手术年龄为2.4岁,术后石膏固定6～8周.结果 268例(308足)全部随访,随访时间12个月～4年,平均2.8年.疗效评定根据足术后的外形、步态、足印、踝关节功能、有无疼痛及影像学检查进行综合评价.优258例294足,良8例10足,一般2例4足.无舟骨坏死发生.结论 Carroll手术是治疗儿童先天性马蹄内翻足畸形的理想方法之一,术前石膏矫正有助于手术矫正畸形,手术疗效与足畸形程度及手术年龄有关.

Carroll procedure for the treatment of congenital clubfoot

Objective To investigate the clinical application of Carroll procedure for congenital clubfoot (CCF).Methods Carroll procedure was applied to treat 268 cases with CCF (Dimeglio type Ⅲ or Ⅳ),including 200 males (230 feet) and 68 females (78 feet).There were 228 unilateral CCF and 40 with bilateral CCF.The mean age at operation was 2.4 years,ranging from 6 months to 10 years.The wounds were fixed with plaster for 6 to 8 weeks postoperatively.Results All cases were followed up postoperatively for 12.months to 4 years,at an average of 2.8 years.According to the results of postoperative appearance,functional recovery and roentgenographic findings,258 patients (294 feet) were evaluated as excellent,8 patients (10 feet) as good and 2 patients (4 feet) as fair.No navicular necrosis was observed.Conclusions Carroll Operation is an effective procedure for CCF.Nonoperative correction before surgery is beneficial for operative treatment.The effect of operation is related to the age at operation and the deformation severity of feet.