摘要
目的 探讨锁定型后足融合髓内钉（TRIGEN）治疗脑瘫后遗症内翻足畸形的临床疗效。方法 随访2019年1月至2024年12月锁定型后足融合髓内钉治疗脑瘫后遗症内翻足畸形12例，男7例，女5例；年龄18-32岁（22.5±4.2岁），观察术后1、6、12、18月X线片及三维CT，踝关节AOFAS及Maryland评分，评价足踝功能。结果 随访6-18月（9.5±3.2月），末次随访踝关节均已融合、跛行改善，踝关节AOFAS及Maryland评分优良率分别为81%（9/12）及84%（10/12），术前与术后其他时间踝关节AOFAS、Maryland评分有显著差异（F＜0.001）。另外，所有患者术后18月的SF-36评分较术前改善，差异有统计学意义（F＜0.001）。结论 锁定型后足融合髓内钉治疗脑瘫后遗症内翻足畸形，矫形满意、固定牢固、创伤小、早期下地活动，有效改善行走跛行。
关键词： 内翻足；踝关节；融合
Abstract
Objective To explore the clinical efficacy of locked posterior foot fusion intramedullary nails (TRIGEN) in treating equinovarus deformity due to cerebral palsy sequelae. Methods A follow-up study was conducted on 12 cases treated with locked posterior foot fusion intramedullary nails from January 2019 to December 2024, including 7 males and 5 females; ages ranged from 18 to 32 years (22.5±4.2). Postoperative X-rays and three-dimensional CT scans were observed at 1, 6, 12, and 18 months, along with AOFAS and Maryland scores for the ankle joint to evaluate foot and ankle function. Results Follow-up duration was 6 to 18 months (9.5±3.2). At the last follow-up, all ankle joints had fused, and limping improved, with excellent rates of AOFAS and Maryland scores being 81% (9/12) and 84% (10/12), respectively. There were significant differences in AOFAS and Maryland scores between preoperative and postoperative times (F<0.001). In addition, all patients showed a statistically significant improvement in SF-36 scores at 18 months after surgery compared with preoperative scores (F<0.001). Conclusion The use of locked posterior foot fusion intramedullary nails for treating equinovarus deformity due to cerebral palsy sequelae results in satisfactory correction, stable fixation, minimal trauma, early mobilization, and effective improvement in walking ability.
Key words： Varus foot; Ankle joint; Fusion
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