Ponseti方法治疗先天性马蹄内翻足

目的　讨论采用Ponseti方法早期保守治疗先天性马蹄内翻足的疗效。方法　 2 0 0 0年1月至 2 0 0 2年 10月 ,我院骨科采用Ponseti方法治疗先天性马蹄内翻足 38例 ,35例为单纯性马蹄内翻足 ,3例伴发于多关节挛缩畸形。男 32例 ,女 6例。单侧 2 2例 ,双侧 16例 ,共 5 4足 ,年龄 7d～ 6个月。结果　所有病例平均随访期 12 .7个月 ,最长 2 6个月。 35例单纯性马蹄内翻足患儿外观畸形纠正 ,皮下跟腱可及 ,踝关节背屈 >0° ,内收 0°,高弓消失 ,跟骨无内翻。已行走的患儿跟腱有力 ,足发育良好 ,关节功能良好 ,步态正常 ,X Ray表现正常。 3例多关节挛缩马蹄足畸形纠正 ,残留少量内收畸形。结论　Ponseti方法保守治疗先天性马蹄内翻足可获得令人满意的疗效 ,结合国外随访报道远期疗效佳 ,肯定了Ponseti方法是一种很好的早期治疗先天性马蹄内翻足的保守疗法。

Ponseti treatment of congenital clubfoot

Objective To evaluate the results of Ponseti method as an early conservative treatment for infants with congenital clubfoot. Methods Thirty-eight infants ( male 32 and female 6, aged from 7 days to 6 months) were managed with Ponseti method in this hospital from Jan. of 2000 to Oct. of 2002. The unilateral deformation occurred in 22 infants and bilateral deformation in 16 patients. There were 3 patients who were associated with multiple joint contractures.Results All infants were followed up for average 12.7 months. In patients without multiple joint contractures group, the ankle appearances were recovered normal, the angle of ankle dorsiflexion was larger than 00 and the angle of ankle adduction was 00, and there was no calcanean varus in these patients. Although the deformation of ankle varus could be completely corrected in 3 patients with multiple joint contractures, mild ankle adduction could be noted in these patients during follow-up.Conclusions The satisfactory results can be gained using Ponseti method to treat patients with congenital clubfoot.