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儿童严重足部畸形矫治在临床上是一较棘手的问题。笔者于1989年1月～1993年5月利用以跗骨部分松质骨刮除术为主的手术治疗重度马蹄内翻足畸形18例22足,取得较满意的疗效。1 临床资料与方法 一般资料:本组18例22足中,男10例,女8例;手术年龄5～14岁,平均9.6岁,病程均4年以上。病因:脊髓灰质炎后遗症10例,先天性马蹄内翻足8例。 手术方法:术前摄X线片,拟定需要刮除的跗骨部位及范围,采取三关节融合切口,尽量保护骨膜、软骨及跗骨窦,远离关节面用尖刀切开跗骨背侧或外侧皮质,使成0.5cm×0.2cm的骨皮质窗,用小而锐利的刮匙刮除松质骨,边刮边扳正马蹄内翻畸形,术后石膏固定4～6周。
Serious foot deformity correction in children is a more difficult clinical problem. From January 1989 to May 1993, the author used 18 cases of 22 cases of severe clubfoot deformity in 18 cases treated mainly by cancellous bone deformity of the stapes, and achieved satisfactory results. 1 Clinical data and methods General information: The group of 18 patients in 22 feet, 10 males and 8 females; operative age of 5 to 14 years, mean 9.6 years, duration of more than 4 years. Etiology: polio sequelae in 10 cases, 8 cases of congenital clubfoot. Surgical methods: preoperative radiography, to develop the need to curettage of stapes and the scope of the site to take three joint fusion incision, try to protect the periosteum, cartilage and tarsal sinus, away from the articular surface with a knife to cut the dorsal or lateral tarsal bone Cortex, so as to 0.5cm × 0.2cm of the cortical window, with a small and sharp scraping spoon to remove cancellous bone, scraping the side while pulling the clubfoot varus, postoperative cast immobilized 4 to 6 weeks.