UNASSIGNED:复发仍然是马蹄内翻足治疗的主要挑战。这项研究的主要目标是确定使用Ponseti方法成功治疗后,超声测量是否与复发有关。此外,确定可能与畸形复发有关的其他因素。
未经评估:76名婴儿(114名特发性马蹄内翻足),对所有采用Ponseti技术治疗的患者进行了回顾.在治疗开始时,所有患者均由同一放射科医师进行超声评估。复发,定义为需要返回Ponseti铸造,在平均5年的随访中记录。通过以下超声测量获得了与复发相关的测量结果:距骨内侧位移(MTa-N),内踝到舟骨距离(MM-N),距骨角度(Ta-C),胫骨远端到跟骨近端骨距(Ti-C)。随后,多变量逻辑回归分析建模复发检查患者的特征,合规,跟腱切开术,和超声波测量。
UNASSIGNED:17例患者的复发率为22%。在单变量分析中,复发与MTa-N增加相关(p=0.038),MM-N降低(p=0.008),并降低Ti-C(p=0.023)。在多变量分析中,我们确定Ti-C是唯一与复发显著相关的超声测量值(p=0.026).本研究中复发的其他重要预测因素是矫形器不依从性(OR=139.0(95%CI:8.7-2224.0),p<10-3),马蹄内翻足治疗中省略经皮跟腱切开术(OR=23.9(95%CI:1.2-493.6),p=0.041)。
UNASSIGNED:治疗开始时的Ti-C超声检查可能是帮助识别畸形复发的高危患者的有用辅助手段。不遵守支撑和省略经皮跟腱切开术也是预测因素。
未经评估:预后研究,三级。
UNASSIGNED: Recurrence remains the main challenge in the treatment of clubfoot. The primary goal of this
study is to determine if ultrasound measurements are associated with recurrence after successful management with the
Ponseti method. Furthermore, other factors are identified which can be associated with recurrence of the deformity.
UNASSIGNED: Seventy-six infants (114 idiopathic clubfeet), all treated with the Ponseti technique were reviewed. All patients had an ultrasound evaluation by the same radiologist at the beginning of the treatment. Recurrence, defined as the need to return to
Ponseti casting, was recorded at a mean follow-up of 5 years. Measurements of association with recurrence were obtained for the following ultrasound measures: the medial talonavicular displacement (MTa-N), the medial malleolus to navicular distance (MM-N), the talocalcaneal angle (Ta-C), and the distal tibial physis to proximal calcaneal apophysis distance (Ti-C). Subsequently, a multivariate logistic regression analysis modeling recurrence examined patients\' characteristics, compliance, Achilles tenotomy, and ultrasound measurements.
UNASSIGNED: Recurrence rate was 22% noted in 17 patients. On univariate analysis, relapse was associated with increased MTa-N (p = 0.038), decreased MM-N (p = 0.008), and decreased Ti-C (p = 0.023). On multivariate analysis, we identified the Ti-C as the only ultrasound measurement significantly associated with recurrence (p = 0.026). Other significant predictors for relapse in this
study were noncompliance with orthosis (OR = 139.0 (95% CI: 8.7-2224.0), p < 10-3), and omitting percutaneous Achilles tenotomy in clubfoot treatment (OR = 23.9 (95% CI: 1.2-493.6), p = 0.041).
UNASSIGNED: The Ti-C sonographic measurement at the start of treatment can be a useful adjunct to help identify high-risk patients for recurrence of deformity. Non-compliance with bracing and omitting percutaneous Achilles tenotomy are also predictive factors.
UNASSIGNED: Prognostic
study, Level III.