外伤后继发痉挛性平足症的诊疗体会

目的：探讨外伤后继发痉挛性平足症的诊断和治疗方法。方法：2002年至2007年收治此类患者7例，在硬膜外麻醉或腓总神经阻滞麻醉下，运用手法按摩惠侧腓骨肌约5rain，被动内外翻踝关节，等到感觉肌肉松弛，再强力内翻内收患足，用短腿管形石膏使其固定于内翻内收矫扭过正住，持续固定3周，3周后拆除石膏，给予理疗，积极进行功能训练。结果：所有患者跛行和足部疼痛均明显好转，足部畸形纠正，足弓恢复正常。随访半年未再复发。结论：外伤后继发痉挛性平足症的诊断依靠仔细询问外伤病史，结合查体和X线拍片等检查。腓总神经阻滞麻醉下手法加石膏外固定是治疗外伤后继发痉挛性平足症的一种简单有效方法。

Diagnosis and treatment of post traumatic spasmodic flat foot

Objective: To discuss diagnosis and treatment of post traumatic spasmodic flat foot. Methods: From 2002 to 2007,7 diagnosed patients were recruited and underwent following procedures:under epidural anesthesia or common peroneal nerve block anesthesia,massage was performed on the peroneal muscles for about 5 minutes,then ankle joint was underwent with passive functional exercise. Feeling muscle relaxation,we held the wounded foot in varus and adducted position forcefully,then immobilized it with short leg cast. After 3 weeks of continuous immobilization,the cast was removed and patients were given physical treatment and functional training. Results: Symptoms of these patients such as claudication and pain in foot were improved,the foot deformity was corrected and foot arch restored to normal. After a follow-up of 6 months,no obvious recurrence was observed. Conclusion: The diagnosis of post traumatic spasmodic flat foot is based on the careful inquiry of traumatic history,physical examination and X-ray results. Manipulative reduction under common peroneal nerve block anesthesia and cast immobilization is a simple and effective method to treat this disease.