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

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. cirrhosis，and 90 had Child-Pugh class C cirrhosis，and 35 individuals who under－went physical examination during the same period of time were enrolled as controls. The indices including liver function parameters，liver fibrosis indices，and platelet count were measured and analyzed. Results：There were significant differences between the two groups in hyaluronic acid（HA），laminin（LN），type Ⅲ collagen（PC-Ⅲ），type Ⅳ collagen（Ⅳ-C），aspartate aminotransferase（AST），alanine aminotransferase（ALT），and aspartate aminotransferase-to-platelet ratio index（APRI）（P<0.05）. HA，PC-Ⅲ，Ⅳ-C，LN，and AST had an area under the ROC curve of 0.910，0.804，0.833，0.753，and 0.730，respectively. HA，PC-Ⅲ，and Ⅳ-C were positively correlated with Child-Pugh class（r>0.7，P<0.01），and APRI was positively correlated with Child-Pugh score（0.4