微创多平面软组织松解术治疗先天性马蹄内翻足的短期疗效

Short-term efficacy of minimally invasive multi-planar soft tissue lysis in treatment of congenital clubfoot

摘要:

目的：探讨微创多平面软组织松解术治疗先天性马蹄内翻足的短期疗效。方法：回顾性分析本院2014年7月至2017年6月采用微创多平面软组织松解术治疗的32例（45足）先天性马蹄内翻足患儿，收集治疗前和最近一次随访的Dimeglio评分和X片6个角度参数，比较治疗前后疗效，相关性分析评价Dimeglio评分与角度的关系。结果：本组所有病例均获得随访，平均随访（12.6±4.8）个月（最小6.2个月，最大24.9个月），最近一次随访中位Dimeglio评分为2.0（1，3）分，较治疗前明显改善（P=0.000）。X片的6个角度均有明显变化（P<0.05），相关性分析提示正位距骨-第1跖骨角与Dimeglio评分呈正相关（系数为r=0.346，P=0.020）。结论：微创多平面软组织松解术治疗先天性马蹄内翻足手术创伤小，术后疤痕不明显，踝关节功能及柔韧性良好，近期疗效满意。

Abstract:

Objective：To investigate the short-term efficacy of minimally invasive multi-planar soft tissue lysis in the treatment of congenital clubfoot. Methods：A retrospective analysis was performed on 32 patients（45 feet） with congenital clubfoot who underwent minimally invasive multi-planar soft tissue lysis in our hospital from July 2014 to June 2017. The Dimeglio scores and the degrees of six angles on X-ray before treatment and at the last follow-up were collected. The efficacy was evaluated and the correlations between Dimeglio score and degrees of six angles were analyzed. Results：All patients were followed up for （12.6±4.8） months（ranged from 6.2 to 24.9 months）. The median Dimeglio score at the last follow-up was 2.0（1，3），which was significantly better than that before treatment（P=0.000）. There were significant changes in the degrees of six angles on X-ray after treatment（P<0.05）. Only the degree of the anteroposterior talus-first metatarsal angle was positively correlated with Dimeglio score（r=0.346，P=0.020）. Conclusion：Minimally invasive multi-planar soft tissue lysis has good short-term efficacy because of its minimal invasion，unobvious postoperative scar，and good outcomes in ankle joint function and flexibility in the treatment of congenital clubfoot