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Objective To explore the changes of metatarsal arrangement and their association with forefoot adduction after modified Mckay procedure.
目的：探讨先天性马蹄内翻足患儿的跖骨排列改变以及其与改良Mckav术后前足内收的关系。
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Children with CTEV have some disarrangement of the metatarsals and the degree of disarrangement is one of the major causes of postoperative forefoot adduction or recurrence of the deformity.
CTEV患足的跖骨排列存在一定程度的紊乱，其紊乱程度是造成术后前足残留内收畸形或畸形复发的主要原因之一。
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Methods Ten fresh-frozen foot specimens, three-dimensional kinematics of talonavicular joint were determined in the case of neutral position, dorsiflexion, plantoflexion, adduction, abduction, inversion and eversion motion by means of three-dimensional coordinate instrument （Immersion MicroScribe G2X） before and after calcaneocuboid arthrodesis under non-weight with moment of couple, bending moment, equilibrium dynamic loading.
方法10只新鲜尸体足标本，通过建立非负重位尸体足模型，结合力偶矩、弯矩及平衡加载方法，应用三维坐标仪测量分析跟骰关节融合前、后距舟关节在大体足背屈、跖屈、内收、外展、内翻及外翻运动中的三维运动度变化。
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Plantarflexion, inversion, adduction and shortening deformities were corrected by the adjustment of the distance between each part of the external bone fixing set through extension, compression, and rotation, etc., and navicular and cuboid osteotomy.
通过对骨外固定装置各部件间距进行延长、压缩和旋转等调节，以及舟、骰骨的截骨延长，从而矫正畸形足的跖屈、内翻、内收及短足畸形。
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The rate of excellent and good clinical results was 83.3％. Mild forefoot adduction was left in 2 feet of 2 cases and quite obvious tarsal articular ankylosis was found in 4 feet of 4 cases; however, there were no significant differences of gait and load bearing between these patients and normal children.
有2例2足遗留轻度前足内收畸形，4例4足有较明显的跗骨间关节僵硬，但其步态和负重力线均与正常儿童无明显差别。
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In accordance with pathological changes and requirements for correctioning talipes equinus,cavus,calcaneus and forefoot varus or valgus,four standard external fixators were designed on the basis of Ilizarov apparatus assembly and tested biomechanically to correct the above.
根据中国患者马蹄足、高弓足、跟行足和前足内收或外翻畸形足的病理改变特点与矫形要求，在Ilizarov环形外固定器构型的基础上，设计完成了标准的矫正马蹄足、高弓足、跟行足和前足内收或外翻的4种外固定矫形器构型，并进行了力学测试。
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We measured the adductor angle and popliteal fossa angle and foot dorsiflexion angle before and after treatment for three times,calculating an average figure and evaluating muscular tension in addition,and calculated the CSS.
将36例痉挛型脑瘫患儿置于体感音乐床聆听中医五行音乐中角音30 min，分别于治疗前后测量3次内收肌角度、双侧腘窝角度、足背屈角度，取其平均值，评估肌张力，计算综合痉挛量表评分。
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Methods A total of 36 cases of cerebral palsy were treated by vibroacoustic therapy and listened to the Jiao Music for 30 minutes.We measured the adductor angle and popliteal fossa angle and foot dorsiflexion angle before and after treatment for three times,calculating an average figure and evaluating muscular tension in addition,and calculated the CSS.
将36例痉挛型脑瘫患儿置于体感音乐床聆听中医五行音乐中角音30 min，分别于治疗前后测量3次内收肌角度、双侧腘窝角度、足背屈角度，取其平均值，评估肌张力，计算综合痉挛量表评分。
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Methods A total of 36 cases of cerebral palsy were treated by vibroacoustic therapy and listen ed to the Jiao Music for 30 minutes.We measured the adductor angle and popliteal fossa angle and foot dorsiflexion angle before and after treatment for three times,calculating an average figure and evaluating muscular tension in addition,and calculated the CSS.
将36例痉挛型脑瘫患儿置于体感音乐床聆听中医五行音乐中角音30 min，分别于治疗前后测量3次内收肌角度、双侧腘窝角度、足背屈角度，取其平均值，评估肌张力，计算综合痉挛量表评分。
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Method］from january 2003 to may 2006,32 patients were corrected with qin si-he's orthotics devices on the ilizarov principle of tension-stress,which involved 15 males and 17 females,the age ranged from 10 to 25 years.among these patients,2 were caused by peroneal nerve injury,l by tumor in the vertebral canal,5 by meningocele,11 were caused by poliomyelitis,13 by congenital talipes equino-varus.in accordance with deformities,external fixator and limitied operative methods were dertermined.the limited release of soft tissue were performed in 7 patients,limited osteotomy in 25 patients.the dynamic muscle balance operation were performed in 9 patients with imbalance of muscle strength.according to the ilizarov technique,the fixative rods were installed.the telescopic rods on the apparatus were rotated one week after the operation,the divices had corrective function in three-dimensional directions.the deformity of talipes equinovarus,internal rotation and drooping of the forefoot were gradually corrected,and the patients could bear weight and walked on the deformed foot.the mean duration of traction were 42 days,then removed the external fixator maintained with plaster for a site time.
方法］2003年1月～2006年5月，根据ilizarov张力应力法则，应用秦泗河改良的外固定矫形器，遵循ilizarov穿针固定的基本原则，共手术治疗马蹄内翻足32例，男15例，女17例；年龄10～25岁，平均17岁。病因：腓总神经损伤2例，腰椎管内肿瘤1例，硬脊膜膨出5例，小儿麻痹后遗症11例，先天性马蹄内翻足13例。术前用足掌的前外缘负重行走者11例，用足的外缘或足背外侧负重者21例。根据马蹄内翻足畸形程度、性质和患者年龄，确定实施有限矫形手术的方法和外固定矫形器治疗。本组7例同期实施有限的软组织松解术，25例同期实施了有限的截骨术和跗骨间关节融合术，9例合并踝关节内外翻肌力明显失衡者，同期行足部肌腱转移的肌力平衡术。然后安装外固定矫形器。术后按作者制定的管理程序，7 d开始旋转相应的螺纹牵拉杆，对器械进行三维空间的缓慢调整，先矫正前足内收和后足内翻，后矫正足下垂畸形，直至达到矫形要求的标准。在矫形的过程中定期进行x线检测，以防止发生踝关节前后移位，治疗期间允许患足负重行走。术后平均牵伸42 d，拆外固定器后患足再上石膏固定适当时间。
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Decorticate rigidity：去皮层强直
此外,还可以出现去小脑强直(decerebrate rigidity)或去皮层强直(decorticate rigidity),前者表现为上肢伸直、内收内旋,腕指屈曲、下肢伸直、内收内旋、踝跖屈、足内翻;后者表现为上肢屈曲、内收内旋、腕指屈曲,下肢与前者相同.
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steppage gait：跨阈步态
F5.跨阈步态(steppage gait)由于踝部肌腱、肌肉迟缓,患足下垂,行走时必须抬高下肢才能起步. 见于腓总神经麻痹. F6.剪刀步态(scissors gait)由于双下肢肌张力增高,尤以伸肌和内收肌张力增高明显,移步时下肢内收过度,两腿交叉呈剪刀状.
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metatarsus adductus：跖内收
畸形足 (Clubfoot)畸形足,又称为马蹄内翻足或杵状足,乃特指脚跟紧缩、内翻、前脚内收的一种先天 性足部异常,它与跖内收(metatarsus adductus)、仰趾外翻足(calcaneo-valgus foot)或姿势性内翻足是不一样的,它并不能轻易地被扳回正常位置.
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talipes equinovarus：马蹄内翻足
马蹄内翻足(talipes equinovarus)是一种最常见的先天性畸形足,约占先天性足部畸形的77%.马蹄内翻足畸形由足下垂,内翻,内收三种因素组成.患者可以伴有其他畸形,如先天性髋关节脱位,并指,肌性斜颈等.本病因患儿一出生就能发现,多数治疗及时,疗效较好