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- Title
Ponseti 方法治疗先天性马蹄内翻足 侧位 X 线片距骨跟骨角的特点及对 复发的预测价值研究.
- Authors
李敬春; 徐晨晨; 黎艺强; 刘远忠; 徐宏文
- Abstract
Purpose To explore the characteristics of the talus and calcaneal angle on early X-ray films of infants with clubfoot treated by Ponseti method and its clinical value in predicting the recurrence of clubfoot. method A total of 119 children with congenital clubfoot who were admitted to Guangzhou Women and Children's Medical Center from January 2002 to September 2013 were collected and followed up, with a total of 177 feet. The patients were divided into recurrence group (33 cases) and non-recurrence group (86 cases) according to the presence or absence of recurrence. The initial treatment age of the children was all less than 6 months, and the Ponseti method was used for serial plaster immobilization to correct foot adduction and varus and back dorsiflexion less than 15°, and Achilles tendon release was performed. Lateral X-rays were taken under the dorsiflexion stress of the foot within 3 months after the release of the Achilles tendon, and the lateral talus-calcaneus angle (TC_L) was measured. The TC_L characteristics of normal and affected feet in children with clubfoot were analyzed. The relationship between the size of TC_L in all clubfoot and prognosis was analyzed. Logistic regression was used to judge the predictive value of early TC_L on clubfoot recurrence. result In this study, there was no significant difference between the recurrence group and the non-recurrence group in gender, age of Achilles tendon release, and X-ray examination age within 3 months after Achilles tendon release ( P =0.83, 0.57, 0.17, respectively). ). Compared with TC_L, the recurrence group (34.38°±10.99°) was significantly different from the non-recurrence group (40.72°±12.86°) ( P < 0.001). There was a statistically significant difference between the affected foot (38.56°±11.57°) and the normal foot (50.91°±9.26°) in unilateral children ( P < 0.001). The area under the ROC curve of the talus and calcaneal angle in predicting clubfoot recurrence was 0.6629 ( χ 2 =8.2567, P =0.0041), and the optimal critical point of the talus-calcaneal angle was 40°. in conclusion The talus and calcaneal angle of congenital clubfoot treated by Ponseti method and 3 months after Achilles tendon release were significantly smaller than the normal value, which has a certain value in predicting recurrence. The smaller the talar-calcaneal angle, the greater the likelihood of recurrence.
- Publication
Journal of Clinical Pediatric Surgery, 2022, Issue 8, p714
- ISSN
1671-6353
- Publication type
Article
- DOI
10.3760/cma.j.cn101785-202205068-003