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외상 후 발생한 심한 족관절 첨족 변형의 2단계 수술적 치료방법- 예비보고 -

Two Staged Surgical Treatment of Post-Traumatic Severe Ankle Equinus Deformity -Preliminary Report-

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Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient’s satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we’ve obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We’ve also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient’s satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

Abstract

Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient’s satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we’ve obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We’ve also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient’s satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

참고문헌 (26)

  1. Garbarino JL, "A geometric method of calculating tendo Achillis lengthening", J Pediatr Orthop, 5, pp.573~576 (1985)
  2. Lee DY, "Management of recurred spastic equinus deformity by heel cord advancement in cerebral palsy", J Korean Orthop Assoc, 26, pp.1480~1484 (1991)
  3. Choi IH, "Correction of severe foot deformity using ilizarov external fixator", J Korean Orthop Assoc, 27, pp.611~624 (1992)
  4. Ihn JC, "The surgical management of equinus deformity in cerebral palsy", J Korean Orthop Assoc, 28, pp.1192~1197 (1993)
  5. Choi KS, "Surgical correction of equinus or equinovarus deformities in spastic cerebral palsy", J Korean Orthop Assoc, 27, pp.41~49 (1992)
  6. Damron TA, "Chronologic outcome of surgical tendoachilles lengthening and natural history of gastroc-soleus contracture in cerebral palsy. A two-part study", Clin Orthop Relat Res, 301, pp.249~255 (1994)
  7. Steinwender G, "Fixed and dynamic equinus in cerebral palsy: evaluation of ankle function after multilevel surgery", J Pediatr Orthop, 21, pp.102~107 (2001)
  8. Evans D, "Relapsed clubfoot", J Bone Joint Surg Br, 43, pp.722~733 (1961)
  9. Evans EB, "Orthopaedic measures in the treatment of severe burns", J Bone Joint Surg Am, 48, pp.643~669 (1966)
  10. Grill F, "The Ilizarov distractor for the correction of relapsed or neglected clubfoot", J Bone Joint Surg Br, 69, pp.593~597 (1987)
  11. Paley D, "The correction of complex foot deformities using Ilizarov's distraction osteotomies", Clin Orthop Relat Res, 293, pp.97~111 (1993)
  12. Silver CM, "Gastrocnemius-muscle recession (Silfverskiold operation) for spastic equinus deformity in cerebral palsy", J Bone Joint Surg Am, 41, pp.1021~1028 (1959)
  13. Coester LM, "Long-term results following ankle arthrodesis for post- traumatic arthritis", J Bone Joint Surg Am, 83, pp.219~228 (2001)
  14. Hahn SB, "Treatment of severe equinus deformity associated with extensive scarring of the leg", Clin Orthop Relat Res, 393, pp.250~257 (2001)
  15. Galardi G, "Peripheral nerve damage during limb lengthening. Neurophysiology in five cases of bilateral tibial lengthening", J Bone Joint Surg Br, 72, pp.121~124 (1990)
  16. Grant AD, "Ilizarov technique in correction of foot deformities: a preliminary report", Foot Ankle, 11, pp.1~5 (1990)
  17. Green SA, "Complications of external skeletal fixators", Clin Orthop Relat Res, 180, pp.109~116 (1983)
  18. Talyshinsky RR, "Analysis of causes of unsatisfactory outcomes of surgery in deformities of the foot and their prevention", Ortop Travmatol Protez, 1, pp.130~135 (1971)
  19. Rhee YG, "Ilizarov technique in the correction of equinus deformity", J Korean Orthop Assoc, 31, pp.770~777 (1996)
  20. Kitaoka HB, "Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes", Foot Ankle Int, 15, pp.349~353 (1994)
  21. Tasto JP, "Arthroscopic ankle arthrodesis", Instr Course Lect, 49, pp.259~280 (2000)
  22. Stranks GJ, "Anterior ankle arthrodesis with cross-screw fixation. A dowel graft method used in 20 cases", J Bone Joint Surg Br, 76, pp.943~946 (1994)
  23. Chuinard EG, "Distraction-compression bone-graft arthrodesis of the ankle. A method especially applicable in children", J Bone Joint Surg Am, 45, pp.481~490 (1963)
  24. Maurer RC, "Transarticular cross-screw fixation. A technique of ankle arthrodesis", Clin Orthop Relat Res, 268, pp.56~64 (1991)
  25. Moeckel BH, "Ankle arthrodesis. A comparison of internal and external fixation", Clin Orthop Relat Res, 268, pp.78~83 (1991)
  26. Eylon S, "Outcome of Ilizarov ankle arthrodesis", Foot Ankle Int, 28, pp.873~879 (2007)

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