Ponseti技术中经皮跟腱切开术的疤痕特征-横断面研究

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-04 DOI:10.1016/j.jcot.2025.103090

Varun Garg, Anil Agarwal, Kishmita Sachdeva, K.S. Ankitha

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引用次数: 0

摘要

马蹄内翻足是一种常见的先天缺陷，通常采用Ponseti法进行治疗。在大多数病例中，每周一次的密集铸造和跟腱切开术是最后一步。经皮跟腱切断术的肌腱切断术疤痕可能会引起美观问题，影响父母的满意度或妨碍鞋子的使用。本研究旨在客观评价经皮跟腱切开术在Ponseti治疗过程中的疤痕特征以及家长对其的看法。方法本研究纳入特发性内翻足患儿，1岁前采用Ponseti方案经皮跟腱切断术治疗，2 ~ 4岁采用支具治疗。采用温哥华疤痕量表（VSS）和患者与观察者疤痕评估量表（POSAS 2.0）评估疤痕质量。并发症如肥大、瘢痕疙瘩形成、支具困难、穿鞋困难和行走困难。结果本研究评估了50例儿童（男35例，女15例）的82例瘢痕。在最后的随访中，大多数疤痕接近正常皮肤。VSS评分的平均值为3.0±1.0、1.2±0.5、2.2±2.1。所有的孩子都能穿着正常的鞋子走路，并积极参加户外活动，没有出现增生性疤痕或瘢痕疙瘩形成等并发症。结论经皮肌腱切断术瘢痕最小，不影响儿童的一般功能。疤痕的美学特征被父母所接受。经皮肌腱切开术的使用不应因担心留下疤痕而受到限制。

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Scar characteristics of percutaneous Achilles tenotomy in Ponseti Technique-A cross-sectional study

Background

Clubfoot, a common birth defect, is treated with the Ponseti method. It involves an intensive phase of weekly casting and Achilles tenotomy as the last step in most of the cases. The tenotomy scar of percutaneous Achilles tenotomy may cause aesthetic concerns that could affect parental satisfaction or impede footwear use. This study aims to objectively evaluate the scar characteristics of percutaneous Achilles tenotomy during Ponseti treatment and parental perception of the same.

Methods

This study enrolled children with idiopathic clubfoot treated by Ponseti protocol with percutaneous Achilles tenotomy before 1 year of age and on bracing protocol between 2 and 4 years. The Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS 2.0) were used to assess scar quality. Complications such as hypertrophy, keloid formation, brace difficulty, footwear difficulty, and walking difficulties were noted.

Results

The study evaluated 82 scars in 50 children (35 males, 15 females). At the final follow-up, most of the scars were close to the normal skin. The mean value of the VSS and overall opinion of the observer and parents regarding the scar was 3.0 ± 1.0, 1.2 ± 0.5 and 2.2 ± 2.1 respectively. All children were able to walk using normal shoes and actively take part in outdoor activities and no complications such as hypertrophic scar or keloid formation were seen.

Conclusion

Percutaneous tenotomy causes minimal scarring and does not interfere with the general functioning of the child. The aesthetic characteristics of the scar are well-accepted by the parents. The use of percutaneous tenotomy should not be limited by the concern of a scar.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.