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首页> 外文期刊>Open Journal of Urology >Lateral Intra-Articular Transposition of the Anterior Tibialis Tendon for the Treatment of Relapsed Clubfoot in Toddlers: A Previously Unreported Surgical Technique
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Lateral Intra-Articular Transposition of the Anterior Tibialis Tendon for the Treatment of Relapsed Clubfoot in Toddlers: A Previously Unreported Surgical Technique

机译：胫骨前肌腱的横向关节内移位治疗幼儿复发性马蹄内翻：先前未报道的手术技术

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Dynamic supination of the foot is a common residual deformity in children with clubfeet treated with the Ponseti method. Transfer of the anterior tibialis tendon (ATT) to the lateral cuneiform is an effective method for correcting this deformity when the cuneiform is ossified in children who are 3 to 5 years of age. We describe two cases of a previously unreported method of ATT transposition for correction of bilateral residual dynamic supination in a 26-month-old and a 19-month-old patient. Both patients presented shortly after birth with bilateral congenital idiopathic clubfoot and were initially treated with the Ponseti method. Both had residual deformity following initial treatment that included posterior contracture and metatarsus adductus with dynamic forefoot supination. This was surgically corrected with a posterior release and medial release of the 1st metatarsal/1st cuneiform joint. To correct dynamic supination, the ATT was transplanted laterally into the released midfoot joint. These two patients were followed post-operatively for 7.5 years and have correction of their residual deformity in both feet based on subjective functioning, appearance, range of motion, strength, and gait. Both have excellent lateral pull of their ATT, which functions as a strong foot dorsiflexor. No residual supination is present. This is the first report of lateral transposition of the ATT as an interposition graft at the released 1st metatarsal/1st cuneiform joint in patients with relapsed clubfoot. We suggest that this method should provide a high level of functioning in children with relapsed supination deformity and whose 3rd cuneiform has not yet ossified.
机译：脚动态旋后是采用庞塞迪方法治疗的马蹄内翻小儿常见的残余畸形。当楔形骨在3至5岁的儿童中骨化时，胫骨前肌腱（ATT）转移到外侧楔形骨是纠正这种畸形的有效方法。我们描述了两个未曾报道过的ATT移位方法，用于纠正26个月大和19个月大的患者双侧残余动态旋后的情况。两名患者在出生后不久就出现了双侧先天性特发性马蹄内翻足，最初接受了庞塞替方法治疗。最初治疗后，两者均具有残余畸形，包括后挛缩和meta骨前收肌伴动态前足旋后。通过第一with骨/第一楔形关节的后部释放和内侧释放进行手术纠正。为了纠正动态旋后，将ATT侧向移植到已释放的足中关节中。这两名患者术后均接受了7.5年的随访，并根据主观功能，外观，运动范围，力量和步态对双脚的残余畸形进行了矫正。两者的ATT均具有出色的侧向拉力，可作为强大的脚背屈肌。没有残留的旋后。这是关于马蹄足复发患者在第一1骨/第一楔形关节释放的ATT侧向移位的一种报道。我们建议这种方法应为旋后畸形复发且第三楔形骨尚未骨化的儿童提供高水平的功能。

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