■为了定量评估Ponseti方法矫正马蹄足的有效性,我们决定使用磁共振成像(MRI)来评估髌骨关系的变化.
■这是一项对15例接受Ponseti方法治疗的马蹄内翻足患儿的回顾性研究。MRI研究是使用3.0T机器(GEHealthcare,美国)。T1加权和T2加权图像在标准解剖矢状位,横向,和日冕平面。对于测量,选择了清楚显示解剖结构的最佳切片。矢状距骨角度,矢状胫骨角,冠状胫骨角,横向距骨颈角,横向距骨角度,并测量了横向距骨角度。使用Pirani评分系统和MRI在临床和放射学水平上比较了18只矫正的马蹄足与12只单侧正常足,分别。
■总共,用MRI检查了15例(男孩12例,女孩3例)。12例单侧,3例双侧受累(11例左马蹄足和7例右马蹄足),与12只正常脚相比,总共有18只。检查时患者的平均年龄为47.7个月(8-96个月)。这些患者的矫正马蹄内翻足的恢复达到了Ponseti治疗的目标(功能性,看起来正常,无痛,和平坦的脚)。在Ponseti治疗之前,马蹄内翻足的平均皮拉尼评分为5.5(5-6).在后续行动中,Pirani评分为0.07(0-0.05)。MRI的结果表明,在治疗的马蹄内翻足和正常足之间,只有横向距骨角度显示显著差异(p<0.001)。矢状面背侧距骨关节半脱位1例,横切面外侧舟骨半脱位1例,这在以前的研究中从未报道过。
■尽管在Ponseti方法后,马蹄内翻足的外观和功能恢复良好,MRI结果表明,Ponseti方法成功地纠正了内翻,cavus,和马蹄畸形,不完全纠正了横向距骨角度的内收畸形。同时,在MRI上,Ponseti方法可能会导致矢状面的距骨背侧半脱位和横向面的舟骨外侧半脱位。
UNASSIGNED: To quantitatively evaluate the effectiveness of the Ponseti method for the correction of clubfoot, we decided to use magnetic resonance imaging (MRI) to evaluate changes in the tarsal bone relationship.
UNASSIGNED: This is a retrospective
study of fifteen children with clubfeet who were treated with the Ponseti method. MRI studies were obtained using a 3.0T Machine (GE Healthcare, United States). T1-weighted and T2-weighted images were acquired in the standard anatomic sagittal, transverse, and coronal planes. For the measurement, the best slice that clearly demonstrated the anatomy was chosen. Sagittal talocalcaneal angle, sagittal tibiocalcaneal angle, coronal tibiocalcaneal angle, transverse talar neck angle, transverse talonavicular angle, and transverse talocalcaneal angle were measured. The eighteen corrected clubfeet were compared with the twelve unilateral normal feet at clinical and radiological levels using a Pirani scoring system and MRI, respectively.
UNASSIGNED: In total, 15 cases (twelve boys and three girls) with clubfeet were examined by using MRI. Twelve cases had unilateral and three had bilateral involvement (eleven left clubfeet and seven right clubfeet), giving a total of eighteen clubfeet when compared with twelve normal feet. The mean age of patients at examination was 47.7 months (8-96 months). The recovery of the corrected clubfoot in these patients met the goals of Ponseti treatment (functional, normal looking, pain-free, and plantigrade foot). Before Ponseti treatment, the mean Pirani score of clubfoot was 5.5 (5-6). During this follow-up, the Pirani score was 0.07 (0-0.05). The results of the MRI indicated that only the transverse talonavicular angle showed a significant difference between the treated clubfeet and the normal feet (p < 0.001). One case had dorsal talonavicular subluxation in the sagittal plane and had the lateral subluxation of the navicular in the transverse plane, which has never been reported in previous studies.
UNASSIGNED: Although the appearance and function of clubfoot were recovered well after the Ponseti method, the results of MRI indicated that the Ponseti method successfully corrected the varus, cavus, and equinus deformities and incompletely corrected the adduction deformity regarding transverse talonavicular angle. At the same time, the Ponseti method may cause dorsal talonavicular subluxation in the sagittal plane and lateral subluxation of the navicular in the transverse plane on MRI.