根据足部畸形的刚性程度评估先天性足内翻畸形的严重程度分级
- 作者: Vlasov M.V.1
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隶属关系:
- Privolzhsky Research Medical University
- 期: 卷 14, 编号 3 (2024)
- 页面: 359-368
- 栏目: Original Study Articles
- URL: https://journals.rcsi.science/2219-4061/article/view/268210
- DOI: https://doi.org/10.17816/psaic1799
- ID: 268210
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详细
现实性。目前开发的先天性足内翻畸形的分级和分类主要基于对足部病变临床症状的评估,这使得难以对足部畸形的刚性程度进行定量评估。基于足部刚性指数的分级方法能够为每位患者制定个性化的长期治疗方案。
目的。基于足部刚性指数开发先天性足内翻畸形的严重程度分级。
材料和方法。在治疗229名(350只脚)典型先天性足内翻畸形儿童之前,采用Ponseti方法进行了临床动力学检查,并随后计算了足部刚性指数。确定了I–II、III和IV级先天性足内翻畸形患者消除足部畸形所需的石膏数量。在分析先天性足内翻畸形的临床动力学指标之间的相关关系时,采用了Spearman等级相关法。差异在p < 0.05时被认为是显著的。
结果。对儿童先天性马蹄内翻足的Ponseti治疗方法的回顾性分析发现了一些规律:矫正轻度畸形所需的石膏绷带数量少于矫正重度畸形的数量,而轻度先天性马蹄内翻足的脚部刚性指数低于重度畸形。通过Spearman相关分析,识别出了“脚部刚性指数”这一标准,其在研究特征之间有着较强的相关性,并且具有很高的统计显著性(p = 0.001)。根据初始的脚部刚性指数,先天性马蹄内翻足被分为三种形式:可动型、刚性型和极刚性型。可动型马蹄内翻足的刚性指数不超过0.2;刚性型的刚性指数在0.21到0.3之间;极刚性型的刚性指数则超过0.31。
结论。脚部刚性指数是评估先天性马蹄内翻足状态的重要标准。根据初始的脚部刚性指数,我们可以将先天性马蹄内翻足分为三种类型:可动型、刚性型和极刚性型。
作者简介
Maksim Vlasov
Privolzhsky Research Medical University
编辑信件的主要联系方式.
Email: footdoc@mail.ru
ORCID iD: 0009-0009-4381-8340
SPIN 代码: 2721-5113
MD, Cand. Sci. (Medicine)
俄罗斯联邦, 18/1 Verkhne-Volzhskaya emb., Nizhny Novgorod参考
- Baindurashvili AG, Solov’yova KS, Zaletina AV, Lapkin YuA. Congenital abnormalities (developmental defects) and musculoskeletal system deformities in children. N.N. Priorov Journal of Traumatology and Orthopedics. 2014;(3):15–20. EDN: STTRPB doi: 10.17816/vto20140315-20
- Kenis VM, Stepanova YuA. Causes of nonoptimal conservative treatment of congenital clubfoot in children. Traumatology and orthopedics of Russia. 2017;23(3):80–85. EDN: ZRXJRX doi: 10.21823/2311-2905-2017-23-3-80-85
- Timaev MKh, Sertakova AV, Kurkin SA, et al. Talipes equinovarus in children (review). Saratov Journal of Medical Scientific Research. 2017;13(3):514–520. EDN: YPTYKW
- Kapitanaki AL, Davletshin RI. Roentgenofunctional basis for surgical tactics in children with congenital clubfoot. Orthopaedics, traumatology and prosthetics. 1987;(1):23–25. EDN: ZETFAX (In Russ.)
- Gafarov KhZ, Baibekov ShA. Surgical method of prevention of recurrence of torsion pathology of the shin bones and talipes. Orthopaedics, traumatology and prosthetics. 1990;(10):48–51. (In Russ.)
- . Kolomiets AA, Ust’iantsev VI. Classification of congenital clubfoot. Orthopaedics, traumatology and prosthetics. 1990;(9):65–66. EDN: VSALTZ (In Russ.)
- Addison A, Fixsen JA, Lloyd-Roberts GC. A review of the Dillwyn Evans type collateral operation in severe club feet. J Bone Joint Surg Br. 1983;65(1):12–14. doi: 10.1302/0301-620X.65B1.6822595
- Aronson L., Puskarich C.L. Deforming and disability from treated club foot. J Pediat Orthop. 1990;10(1):109–119.
- Catterall A. A method of assessment of clubfoot deformity. Clin Orthop Relat Res. 1991;(264):48–53.
- Hudson I., Catterrall A. Posterolateral release for resistant club foot. J Bone Joint Surg Br. 1994;76(2):281–284.
- Forma E., Elton R.A., Macnicol M.F. The classification of congenital talipes equinovarus. J Bone Joint Surg Br. 2003;85(7):1087–1088.
- Bogdanov F.R., Melikdzhanian Z.G. Congenital clubfoot and its surgical treatment. Orthopaedics, traumatology and prosthetics. 1974;(1):33–37. (In Russ.) EDN: ZYCWPB
- Konyukhov M.P., Lapkin A. Surgical treatment of clubfoot in patients with systemic diseases of the musculoskeletal system. Methodological recommendations. Saint Petersburg; 1989. 12 p. (In Russ.)
- Silk F.F., Wainwrigth D. The recognition and treatment of congenital flat foot in infancy. J Bone Joint Surg Br. 1967;49(4):628–633.
- Ryöppi S., Sairanen H. Neonatal operative treatment of club foot a preliminary report. J Bone Joint Surg Br. 1983;65(3):320–325. doi: 10.1302/0301-620X.65B3.6841404
- Pirani S., Outerbridge H.K., Sawatzky B., Stothers K. A relianle method of clinically evaluating a virgin clubfoot evaluation. In: 21st SICOT Congress. Vol. 29. Sydney, 1999. P. 2–30.
- Dimeglio A., Bensahel H., Souchet P., Bonnet F. Classification of clubfoot. J Pediatr Orthop B. 1995;4(2):129–136. doi: 10.1097/01202412-199504020-00002
- Rumyantseva GN, Rasskazov LV, Murga VV, Marasanov NS. Congenital clubfoot. Literature review. Upper Volga Medical Journal. 2012;10(4):28–31. (In Russ.) EDN: PUJPYV
- Blandinskiy VF, Vavilov MA, Gromov IV. Clubfoot reccurences after the treatment by Ponseti. Traumatology and Orthopedics of Russia. 2013;(1):99–103. (In Russ.) EDN: PWOSOL
- Lasebikan OA, Anetekhai WI, Asuquo JE, et al. Experience with accelerated ponseti technique for treatment of idiopathic clubfoot in a regional orthopaedic hospital in Nigeria. Afr J Paediatr Surg. 2023;20(2):106–108. doi: 10.4103/ajps.ajps_113_21
- Bozkurt C, Bekin Sarikaya PZ, Karayol SS, et al. The evaluation of vascular flow in clubfoot: a resistive index and peak systolic velocity study. J Pediatr Orthop B. 2024;33(1):37–43. doi: 10.1097/BPB.0000000000001063
- Kruglov IYu, Rumyantsev NYu, Omarov GG, Rumiantceva NN. Change in the severity of congenital clubfoot in the first week of life. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2019;7(4):49–56. (In Russ.) EDN: KTAIVD doi: 10.17816/PTORS7449-56
- Mutlu E, Kaymakoglu M, Gunes Z, et al. Assessment of early Achilles tenotomy in the newborn idiopathic pes equinovarus. Acta Orthop Belg. 2022;88(2):231–236. doi: 10.52628/88.2.8547
- Perez EP, Parenti S, Polk J, et al. The Ponseti method for the treatment of clubfeet associated with Down syndrome: a single-institution 18-year experience. J Pediatr Orthop. 2023;43(2):e106–e110. doi: 10.1097/BPO.0000000000002293
- Nguyen-Khac V, De Tienda M, Merzoug V, et al. Well though-out introduction of percutaneous Achilles tenotomy during functional treatment of congenital talipes equinovarus: which indications produce the best results? Orthop Traumatol Surg Res. 2023;109(3):102932. doi: 10.1016/j.otsr.2021.102932
- Blandinsky V.F., Vavilov M.A., Torno T.E., Donskoy A.V. Management of atypical clubfoot by Ponseti method. Traumatology and Orthopedics of Russia. 2010;16(1):75–79. (In Russ.) EDN: LJLVPR
- Ponseti IV. Treatment of congenital club foot. J Bone Joint Surg Am. 1992;74(3):448–454.
- Maranho DA, Volpon JB. Congenital clubfoot. Acta Ortop Bras. 2011;19(3):163–169. doi: 10.1590/S1413-7852201100030001024.
- Sahoo PK, Sahu MM. Neglected clubfoot — a community health challenge in rural Odisha, India. Indian J Orthop. 2023;57(11):1757–1764. doi: 10.1007/s43465-023-00923-5
- Vlasov MV. Rigidity of foot deformity in congenital clubfoot: foot stiffness index. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2024;14(2):173–182. doi: 10.17816/psaic1797
- Klychkova IY, Konyukhov MP, Lapkin YA. Congenital clubfoot. Classification, etiology, pathogenesis, the evolution of treatments (literature review). Pediatric Traumatology, Othpaedics and Reconstructive Surgery. 2014;2(3):53–63. (In Russ.) EDN: SQKASR doi: 10.17816/PTORS2353-63
- Ponseti V, Smoley EN. The classic: congenital club foot: the results of treatment. Clin Orthop Relat Res. 2009;467(5):1133–1145. doi: 10.1007/s11999-009-0720-2
- Dyer PJ, Davis N. The role of the Pirani scoring system in the management of clubfoot by the Ponseti method. J Bone Joint Surg Br. 2006;88(8):1082–1084. doi: 10.1302/0301-620X.88B8.17482
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