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目的探讨先天性马蹄内翻足(CCF)患儿治疗前预测患儿行跟腱手术的可行性。方法96例CCF(148足)患儿,均依据Ponseti方法治疗,平均(5.7±1.3)次石膏矫正后,背屈活动≤15°或Pirani评分HS(后足评分)≥1,MS(中足评分)<1的患足需行跟腱切断手术。石膏去除后需佩戴外展支具。结果经过系列石膏矫正后,148足中125足(84.5%)行跟腱切断术,23足(15.5%)未行跟腱手术。在治疗初有102足(68.9%)Pirani评分≥5分,其中93足(91.2%)经系列石膏矫正后行跟腱手术。手术组跟腱愈合佳,跖屈有力。结论在治疗初Pirani评分≥5分时91.2%患儿需要跟腱手术,CCF患儿初次来诊时,对患足行Pirani评分,即可预测其是否需行跟腱手术。在治疗初预先判断患儿是否需行跟腱手术则既有利于医师了解治疗进展,又能更好地与家长沟通配合治疗进程。
Objective To investigate the feasibility of Achilles tendon surgery in children with congenital clubfoot (CCF) before treatment. Methods Ninety-six children with CCF (148 feet) were treated according to Ponseti’s method. After an average of 5.7 ± 1.3 gypsum correction, dorsiflexion activity ≤15 ° or Pirani score HS (hind paw score) ≥1, MS Score) <1 foot suffering from Achilles tendon to cut off surgery. Gypsum removal to wear outreach brace. Results After a series of plaster castration, 125 feet (84.5%) of 148 feet were treated with Achilles tendon rupture and 23 feet (15.5%) without Achilles tendon surgery. At the beginning of treatment 102 patients (68.9%) Pirani score ≥ 5 points, of which 93 feet (91.2%) after a series of plaster correction Achilles tendon surgery. Surgery group Achilles tendon healing is good, plantar flexion powerful. Conclusions At the beginning of treatment, 91.2% of children with Pirani score ≥5 were required to undergo Achilles tendon surgery. When CCF children first visit, Pirani score may be used to predict whether they need Achilles tendon surgery. In early treatment of children in advance to determine whether the required Achilles tendon surgery is conducive to the physician to understand the progress of treatment, but also to better communicate with parents to cope with the treatment process.