引言平面外翻畸形常见于痉挛型脑瘫(CP)患儿,特别是痉挛型双瘫和痉挛型四肢瘫痪。它是由于未成熟的脚骨上的肌肉失衡造成的,导致后脚外翻,前脚绑架,和关节半脱位。手术干预,像跟骨延长截骨术(CLO),经常被用来矫正这种畸形,但目前尚缺乏在CP患者中使用该药物的客观指南.材料和方法这项回顾性队列研究在Vellore的基督教医学院(CMC)儿科骨科病房检查了CLO在纠正小儿CP患者的平面外翻畸形中的疗效,印度。收集患者记录和射线照片的数据,包括人口统计,术前和术后角度,和手术细节。进行统计分析以评估角度的变化以及与各种因素的关联。结果手术后,跟骨音高有显著增强,外侧距骨第一跖骨角,和Naviculocuboid重叠,如CLO结果所示。然而,胫骨角没有显着变化。观察到年龄之间的关联,粗大运动功能分类系统(GMFCS)水平,额外的手术,和术后角度校正。结论CLO在矫正平面外翻畸形方面显示出希望,随着年龄,GMFCS等级,和合并症影响结果。长期随访对于监测矫正耐久性至关重要。特定的射线照相角度可以洞悉CLO的生物力学效应,但研究的局限性需要谨慎解释.CLO可有效纠正小儿CP患者的外翻畸形,随着年龄,GMFCS等级,和合并症影响结果。需要长期随访和进一步研究,以优化管理策略并增强对手术结果的了解。
Introduction Planovalgus deformity is common in children with spastic cerebral palsy (CP), particularly spastic diplegia and spastic quadriplegia. It results from muscle imbalance over the immature foot skeleton, leading to hindfoot valgus, forefoot abduction, and joint subluxation. Surgical interventions, like calcaneal lengthening osteotomy (CLO), are frequently employed to correct this deformity, but objective guidelines for its use in CP patients are lacking. Material and methods This retrospective cohort study examined the efficacy of CLO in correcting plano valgus deformity in pediatric CP patients at the Pediatric Orthopedic Unit of Christian Medical College (CMC) in Vellore, India. Data from patient records and radiographs were collected, including demographics, pre- and postoperative angles, and surgical details. Statistical analysis was performed to assess changes in angles and associations with various factors. Results After the surgery, there was a notable enhancement in the calcaneal pitch, lateral talo-first metatarsal angle, and naviculocuboid overlap, as shown by the CLO results. However, tibiocalcaneal angles did not show significant changes. Associations were observed between age, Gross Motor Function Classification System (GMFCS) level, additional surgeries, and postoperative angle corrections. Conclusion CLO shows promise in correcting plano valgus deformity, with age, GMFCS level, and comorbidities influencing outcomes. Long-term follow-up is crucial to monitor correction durability. Specific radiographic angles provide insights into CLO\'s biomechanical effects, but study limitations warrant caution in interpretation. CLO effectively corrects plano valgus deformity in pediatric CP patients, with age, GMFCS level, and comorbidities influencing outcomes. Long-term follow-up and further research are needed to optimize management strategies and enhance understanding of surgical outcomes.