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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。

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