Clinical efficacy of staged individualized treatment of severe clubfoot deformity
10.3969/j.issn.1671-8348.2024.15.013
- VernacularTitle:分期个体化治疗重度马蹄内翻足合并下肢复杂畸形的临床疗效
- Author:
Shanglong WANG
1
,
2
;
Yiqiang DUAN
;
Zhou FANG
Author Information
1. 贵州医科大学临床医学院,贵阳 550004
2. 贵州医科大学附属医院关节外科,贵阳 550004
- Keywords:
neurogenic severe clubfoot;
Ilizarov technique;
soft tissue surgery;
bony osteotomy;
deform-ities of the lower limbs;
staging surgery
- From:
Chongqing Medicine
2024;53(15):2319-2323
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of staged individualized surgical method for treating neuromuscular origin severe clubfoot complicating complex lower limb deformity.Methods Ten ca-ses of neurogenic severe clubfoot deformity treated in the Affiliated Hospital of Guizhou Medical University from May 2021 to June 2023 were collected as the research subjects.In the first stage,the soft-tissue release,tendon transfer combined with Ilizarov technique were adopted to correct the clubfoot deformity,and in the second stage,according to the patients' postoperative gait and the degree of lower limb deformity,the patients were given individualized and appropriate osteotomy assisted by the increase of Ilizarov external frame length-ening,supra-ankle osteotomy,and distal femoral osteotomy.The clinical results of treatment in the patients were observed.The American Orthopaedic Association Division of Foot and Ankle Surgery (AOFAS) scores and visual analog scale (VAS) scores were compared between before operation and 1,3,6,12 and 18 months after operation.The lower extremity biodynamic line related imaging parameters were compared between be-fore and 18 months after operation.Results All patients successfully completed the surgery without nerve or vascular injury during and after operation and there were no serious complications such as pinhole or incision infection.All patients were followed up for 16-24 months.The ankle joint AOFAS score at each time point after operation was increased compared with the physical examination before operation (P<0.05),and the VAS score was decreased compared with the physical examination before operation (P<0.05).The lower ex-tremity biodynamic line related imaging parameters at 18 months after operation were significantly improved compared with before operation (P<0.05).Conclusion Adopting the staged individualized surgical method for the treatment of neuromuscular origin severe clubfoot complicating complex deformity of the lower limbs could achieve more satisfactory and relatively ideal therapeutic effect.
