Ilizarov技术矫正足踝畸形的器械研究与临床应用

目的]根据Ilizarov技术的基本原理,研究、探讨矫正不同类别足踝畸形的器械构型、适应证扩展、手术方法与临床应用的效果。方法]根据中国患者马蹄足、高弓足、跟行足和前足内收或外翻畸形足的病理改变特点与矫形要求,在Ilizarov环形外固定器构型的基础上,设计完成了标准的矫正马蹄足、高弓足、跟行足和前足内收或外翻的4种外固定矫形器构型,并进行了力学测试。创新的扩展了Ilizarov矫正瘢痕性马蹄足、类风湿性关节炎和先天性腓骨缺如所致的重度足外翻畸形。结果]新设计的4种足踝外固定器,经过临床应用,证实了器械结构合理,安装与调节方便,牵张应力根据需要能进行适度调整,临床治疗105例足踝畸形患者,均获得满意的畸形矫正与功能恢复,无1例出现较严重的并发症。结论]新设计的4种足踝矫形器构型,结构简便、实用,性能优良、能够满足Ilizarov技术的矫形需求。Ilizarov技术对严重足、踝畸形的矫正,具有其它技术不能替代的满意疗效。

Apparatus assembly and clinical application of Ilizarov technique for correcting ankle and foot deformities

Objective] According to the basic principle of Ilizarov technique,the apparatus assembly,indications,operation methods and clinical effectiveness of Ilizarov technique in the correction of foot and ankle deformities were explored.Method]In accordance with pathological changes and requirements for correctioning talipes equinus,cavus,calcaneus and forefoot varus or valgus,four standard external fixators were designed on the basis of Ilizarov apparatus assembly and tested biomechanically to correct the above four foot deformities.The innovation had expanded Ilizarov technique to correcting scar talipes equinus and severe foot valgus caused by rheumatoid arthritis and congenital fibular deficiency.Result]The clinical applications of the four kinds of external fixators showed reasonable apparatus structure,convenient installation and adequate adjustment of distraction tension.They had been used in 105 cases and achieved satisfactory correction of deformity and functional recovery without severe complications.Conclusion]The four new assemblies of external fixators showed simple structures,good performance,and practicality.Ilizarov technique has played an irreplaceable role in the correction of severe foot and ankle deformities.