不进行腱鞘切除术也能治疗特发性 CTEV 吗?前瞻性研究

Pandiyarajan E, Alok Chandra Agrawal, D. Garg, Santosh Kumar Yadav
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引用次数: 0

摘要

腱索腱膜切开术是采用庞塞蒂技术矫正马蹄内翻足畸形的首选手术。虽然腱膜切开术是最常用的手术,但有 11% 至 50% 的病例会出现并发症。因此,我们一直在寻找一种并发症少、效果与标准腱膜切开术相似的替代方法。其中一种方法是向腓肠肌-足底肌注射 A 型肉毒杆菌毒素,这种毒素可导致肌肉可逆性麻痹,从而延长肌肉单位,便于操作和铸造。在我们的研究中,我们比较了肉毒杆菌毒素与腱膜切开术在矫正儿童后足马蹄内翻症方面的疗效(0.05),两组患者在干预后 3 和 6 周以及干预后 3、6、12 个月的皮拉尼评分和踝关节外展情况。早期研究结果表明,A 型肉毒杆菌毒素可替代常规的腱索韧带切开术,在采用 Ponseti 方法治疗马蹄内翻足的过程中矫正后足马蹄内翻足。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can we treat idiopathic CTEV without tenotomy? A prospective study
Tendoachillis tenotomy is the procedure of choice to correct equinus deformity in Ponseti technique. Though Tenotomy is the most frequently done procedure, is associated with complications in 11% to 50% of cases. So, we were in search of an alternative which would have less complication and will give similar results to a standard tenotomy. One such method is Botulinum toxin type A injection into the gastronemius-soleus muscle which causes reversible paralysis of the muscle leading to lengthening of muscle unit, easy manipulation and casting. In our study, we compared the outcomes of Botulinum toxin with tenotomy in the correction of hindfoot equinus in children (<2>0.05) between the two groups in the post-intervention Pirani score and ankle dorsiflexion was seen at 3&6 weeks and 3,6,12 month post intervention. Average dorsiflexion was around 11±1º in both groups upto 1 year post intervention.Early results shows that Botulinum toxin type A is a good alternative to a routine tendoachillis tenotomy to correct hindfoot equinus in the management of clubfoot by the Ponseti method.
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