Miter构型泰勒空间外固定架治疗重度马蹄高弓足11例临床分析

Clinical analysis of 11 cases of severe equinocavus deformity treated with Taylor Spatial Frame Miter configuration

  • 摘要: 目的:研究Miter构型泰勒空间外固定架治疗重度马蹄高弓足的疗效和安全性。方法:回顾性分析2015年11月至2021年12月于首都医科大学附属北京积水潭医院收治的11例采用Miter构型治疗的马蹄高弓足患者的临床资料,测量手术前后的负重侧位X线的胫骨距骨角(TTA)、侧位距骨—第一跖骨角(Meary角)等影像学指标,记录术前及术后的美国足踝外科学会(AOFAS)踝—后足评分,采用Likert满意度量表对患者进行满意度评价。结果:11例患者全部获得随访,随访时间(36.00±13.05)个月,男 8 例,女 3 例,平均年龄(26.00±10.04)岁,外固定架时间为(121.64±15.35)d。术前 TTA(151.30±10.99)°,术后(117.57±3.32)°回到正常范围,差异有统计学意义(P<0.001);术前Meary角(41.98±9.86)°,术后(-2.43±7.97)°回到正常范围,差异有统计学意义(P<0.001)。术后AOFAS评分〔(81.18±10.74)分〕显著高于术前〔(47.18±15.00)分〕(P<0.001)。9例非常满意,2例满意。6例患者发生了针道感染,1例轻度平足,1例足趾屈曲挛缩畸形,1例前踝撞击,1 例轻度马蹄复发,除前踝撞击予以关节镜骨赘清理外其余均保守治疗改善。结论:使用Miter构型泰勒空间外固定架治疗重度马蹄高弓足效果安全、可靠。

     

    Abstract: Objective:To investigate the efficacy and safety of the treatment for severe equinocavus deformity with Taylor Spatial Frame Miter configuration. Methods:Clinical data of 11 cases of equinocavus patients treated with Miter configuration admitted at Beijing Jishuitan Hospital of Capital Medical University from November 2015 to December 2021 were retrospectively analyzed. The radiological parameters including tibiotalar angle (TTA), lateral talus-1st metatarsal angle (Meary angle) were measured on preoperative and postoperative weightbearing lateral view X-rays. The American Foot and Ankle Society (AOFAS) ankle-hindfoot score was recorded before and after the surgery. The satisfaction rate was evaluated using Liker scale. Results:Eleven cases were included with a mean follow-up time of (36.00±13.05) months. There were 3 females and 8 males with the mean age of (26.00±10.04) years. The external fixation time was (121.64±15.35) days. The postoperative TTA (117.57± 3.32)° returned to normal range and was significant different (P<0.001) compared to the preoperative one (151.30±10.99)°. The postoperative Meary angle (-2.43±7.97)° returned to normal range and was significant different (P<0.001) compared to the preoperative one (41.98 ± 9.86)°. The postoperative AOFAS score (81.18 ± 10.74) was significantly higher than the preoperative one (47.18±15.00) (P<0.001). The Likert scale showed 9 cases of "very satisfied" and 2 cases of "satisfied". Six patients complicated with pin site infections, one developed mild flatfoot, one had toe contractures, one had ankle impingement and one had mild equinus recurrence. All ameliorated by conservative treatment except for arthroscopic debridement for ankle impingement. Conclusion:Severe equinocavus deformity can be treated effectively and safely by the Taylor Spatial Frame Miter configuration.

     

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