通过修改的庞塞蒂方法缩短夜间,具有类似的脚功能和与健康有关的生活质量
Angela Seidel1, Severine Tinembart2, Nadine Kaiser2
1Departement of Orthopedic Surgery and Traumatology, University of Fribourg, Fribourg, CHE.
Cureus
|March 10, 2025
概括
经过修改的Ponseti方法,减少了夜间 splinting 持续时间和阿基里斯肌延长 (ATL),显示了与原始方法可比的临床结果和复发率. 这种方法改善了患者报告的生活质量,提供了更易于管理的治疗计划.
科学领域:
- 整形外科 整形外科 整形外科
- 儿科手术 儿科手术
- 康复医学 康复医学 康复医学
背景情况:
- 庞塞蒂方法是脚治疗的标准,但涉及长达六年的夜间分离期,导致合规性挑战.
- 异形脚症需要有效的治疗策略,以平衡疗效与患者的坚持和长期结果.
研究的目的:
- 评估用修改Ponseti方法治疗的异形足儿童的临床结果,复发率和与健康有关的生活质量.
- 评估夜间分隔时间缩短对治疗成功和患者报告的措施的影响.
主要方法:
- 分析了一组107名儿童 (152名脚) 具有特异性脚,在1994年至2015年期间接受治疗.
- 最初的治疗包括长腿造,为残留变形进行手术纠正 (阿基里斯肌延长和有限的后部释放),然后进行修改后的 splinting 方案.
- 通过图表审查评估临床结果,并使用疾病特异性仪器 (DSI) 和儿科生活质量库存 (PedsQLTM) 评估功能结果.
主要成果:
- 在92.7%的患者中,平均年龄为7.39岁,实现了临床随访.
- 患者平均使用了支柱 7.8 个月全日和 17.3 个晚上.
- 在10年的平均随访期内,平均DSI为74.8,平均PedsQLTM为87.8.
- 复发率为双边9.3%和单边16.8%.
结论:
- 阿基里斯肌延长 (ATL) 结合有限的后部释放和缩短2.1年的 splinting 期,产生了与原始Ponseti方法相似的结果.
- 修改后的方法显示了良好的临床结果,可接受的复发率,以及患者报告的积极的生活质量.
- 这种经过修改的庞塞蒂方法提供了一个可行的替代方案,由于减短了 splinting 持续时间,潜在地改善了患者的遵从性.
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