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Objective To explore the changes of metatarsal arrangement and their association with forefoot adduction after modified Mckay procedure.

目的:探讨先天性马蹄内翻足患儿的跖骨排列改变以及其与改良Mckav术后前足内收的关系。

PARTICIPANTS: Totally 3 cases of children idiopathic multiple contracture, 2 cases of idiopathic clubfoot in children aged more than 10 years old without treatment and 6 cases of postoperative recurrent idiopathic clubfoot were admitted by the Department of Orthopedics of Nanjing Children' s Hospital Affiliated to Nanjing Medical University during 1999 to 2000. All cases manifested abnormal ankylosis and shortening deformity in foot.

对象:1990/2000南京医科大学附属南京儿童医院骨科共收治儿童先天性多发性关节挛缩症3例、未经任何治疗10岁以上的大年龄儿童先天性马蹄内翻足2例、先天性马蹄内翻足术后复发6例,全部病例均表现为足畸形僵硬和短足畸形。

Methods Ten fresh-frozen foot specimens, three-dimensional kinematics of talonavicular joint were determined in the case of neutral position, dorsiflexion, plantoflexion, adduction, abduction, inversion and eversion motion by means of three-dimensional coordinate instrument (Immersion MicroScribe G2X) before and after calcaneocuboid arthrodesis under non-weight with moment of couple, bending moment, equilibrium dynamic loading.

方法10只新鲜尸体足标本,通过建立非负重位尸体足模型,结合力偶矩、弯矩及平衡加载方法,应用三维坐标仪测量分析跟骰关节融合前、后距舟关节在大体足背屈、跖屈、内收、外展、内翻及外翻运动中的三维运动度变化。

Methods From 1989 to now, seventeen cases of paralytic talipes equinovarus were per-formed in a new surgical manner, which was designed by author.

从1989年至现在,由作者设计的新术式治疗17例麻痹性马蹄足内翻畸形。

In accordance with pathological changes and requirements for correctioning talipes equinus,cavus,calcaneus and forefoot varus or valgus,four standard external fixators were designed on the basis of Ilizarov apparatus assembly and tested biomechanically to correct the above.

根据中国患者马蹄足、高弓足、跟行足和前足内收或外翻畸形足的病理改变特点与矫形要求,在Ilizarov环形外固定器构型的基础上,设计完成了标准的矫正马蹄足、高弓足、跟行足和前足内收或外翻的4种外固定矫形器构型,并进行了力学测试。

Spastic equinovarus foot, a major cause of gait disturbance in stroke patients, impairs patients' safety and interferes with the activities of daily living.

痉挛性足内翻是脑中风患者步态障碍常见的原因,其对病人安全及日常活动功能影响甚钜。

Ying was abandoned by his parents when he was only weight 3 pound ; Zou was abandoned by his parents more than 50 days after he was born, he has serious heart problems, pulmonary hypertension and facing life-threatening; Snow is a child with cerebral palsy and has been abandoned; Zhao has serious equinus varus ; Lu leads to congenital absence of anus, this has not yet one month old baby was found in the trash can , and when he was sent to the orphanage he was dying; Run had been abandoned in a county hospital, only because she is a cleft lip and palate baby...

党英被父母遗弃时体重只有三斤多点,蔫蔫的;小邹成出生后被父母遗弃在山东省邹城县医院的过道上长达50多天,严重的心脏病致使他心内膜垫完全缺损、肺动脉高压,面临生命危险;瑞雪是脑瘫患儿,出生时由于硬肿症送到医院抢救,半岁后孩子出现脑瘫迹象,所以被遗弃;赵恒有严重的马蹄足内翻;路通先天无肛,这个还没有满月的娃是在路边的垃圾桶里被人发现的,送到福利院时已经奄奄一息;润润曾经被遗弃在河南一个县城医院里,只因为这是一个唇腭裂的宝宝。。。

Ying was abandoned byhis parents when he was only weight 3 pound ; Zou was abandoned byhis parents more than 50 days after he was born, he has serious heart problems, pulmonary hypertension and facing life-threatening; Snow is a child with cerebral palsy and has been abandoned; Zhao has serious equinus varus ; Lu leads to congenital absence of anus, this has not yet one month old baby was found in the trash can , and when he was sent to the orphanage he was dying; Run had been abandoned in a county hospital, only because she is a cleft lip and palate baby...

党英被父母遗弃时体重只有三斤多点,蔫蔫的;小邹成出生后被父母遗弃在山东省邹城县医院的过道上长达50多天,严重的心脏病致使他心内膜垫完全缺损、肺动脉高压,面临生命危险;瑞雪是脑瘫患儿,出生时由于硬肿症送到医院抢救,半岁后孩子出现脑瘫迹象,所以被遗弃;赵恒有严重的马蹄足内翻;路通先天无肛,这个还没有满月的娃是在路边的垃圾桶里被人发现的,送到福利院时已经奄奄一息;润润曾经被遗弃在河南一个县城医院里,只因为这是一个唇腭裂的宝宝。。。

Method]from january 2003 to may 2006,32 patients were corrected with qin si-he's orthotics devices on the ilizarov principle of tension-stress,which involved 15 males and 17 females,the age ranged from 10 to 25 years.among these patients,2 were caused by peroneal nerve injury,l by tumor in the vertebral canal,5 by meningocele,11 were caused by poliomyelitis,13 by congenital talipes equino-varus.in accordance with deformities,external fixator and limitied operative methods were dertermined.the limited release of soft tissue were performed in 7 patients,limited osteotomy in 25 patients.the dynamic muscle balance operation were performed in 9 patients with imbalance of muscle strength.according to the ilizarov technique,the fixative rods were installed.the telescopic rods on the apparatus were rotated one week after the operation,the divices had corrective function in three-dimensional directions.the deformity of talipes equinovarus,internal rotation and drooping of the forefoot were gradually corrected,and the patients could bear weight and walked on the deformed foot.the mean duration of traction were 42 days,then removed the external fixator maintained with plaster for a site time.

方法]2003年1月~2006年5月,根据ilizarov张力应力法则,应用秦泗河改良的外固定矫形器,遵循ilizarov穿针固定的基本原则,共手术治疗马蹄内翻足32例,男15例,女17例;年龄10~25岁,平均17岁。病因:腓总神经损伤2例,腰椎管内肿瘤1例,硬脊膜膨出5例,小儿麻痹后遗症11例,先天性马蹄内翻足13例。术前用足掌的前外缘负重行走者11例,用足的外缘或足背外侧负重者21例。根据马蹄内翻足畸形程度、性质和患者年龄,确定实施有限矫形手术的方法和外固定矫形器治疗。本组7例同期实施有限的软组织松解术,25例同期实施了有限的截骨术和跗骨间关节融合术,9例合并踝关节内外翻肌力明显失衡者,同期行足部肌腱转移的肌力平衡术。然后安装外固定矫形器。术后按作者制定的管理程序,7 d开始旋转相应的螺纹牵拉杆,对器械进行三维空间的缓慢调整,先矫正前足内收和后足内翻,后矫正足下垂畸形,直至达到矫形要求的标准。在矫形的过程中定期进行x线检测,以防止发生踝关节前后移位,治疗期间允许患足负重行走。术后平均牵伸42 d,拆外固定器后患足再上石膏固定适当时间。

We describe a seven-generation large family with talipomanus and talipes, 175 individuals in this family were involved. 32 affected individuals including 18 males and 14 femals whose clinical features were different and 1 suspicious male were found. The talipomanus were symmetrical, and varus and valgus were caused by vertical talus.

发现一个连续遗传 7 代的手足畸型大家系,共计 175 人,有 32人发病,男性 18人,女性 14 人,可疑男性1人,患者表型复杂轻重不一,但双手均对称屈曲畸形,垂直踞骨导致足内翻或外翻。

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