胫后肌移位矫治41只麻风垂足远期疗效观察
胫后肌移位,,胫后肌移位；垂足；皮下法；骨间法,1临床资料,2手术适应证及手术方式的选择,3疗效评估,4讨论,【参考文献】
【摘要】 目的 探讨胫后肌移位矫治麻风腓总神经麻痹的疗效。方法 笔者对手术适应证及手术方法做了探讨，选择41例麻风垂足病例，应用骨下法或皮下法作为不同的手术方法进行比较。结果 本组41只，显效40只(占98%)，其中优27只，良8只，尚可5只，无效1只。疗效与胫后肌肌力、垂足的畸残程度、跟腱挛缩及手术方法有关。胫后肌对维持足弓有效，为了避免术后足弓变平，笔者选择4例将麻痹的胫前肌取出，末端固定于胫后肌止点，近端缝于腓肠肌，术后未发生足弓变平。对肌腱脱落，笔者做了手术改进。结论 骨间法优于皮下法。【关键词】 胫后肌移位；垂足；皮下法；骨间法
Observation of long-term efficacy of operations on 41 leprous foot-drop with trans-position of the tibialis posterior muscle
WANG Zai-ming,CHEN Jia-kun.
Shanghai Skin Disease & STD Hospital，Shanghai 200443,China
【Abstract】 Objective To determine the operation effect of the tibialis posterior muscular transposition on leprous foot-drop orthopedic.Methods 41 cases of leprous foot-drop underwent the interosseous or subcutaneous method for operation.Results The operation for 41 cases showed that it was effective in 40 of them (98%),excellent in 27,good in 8,medium in 5 and in-effective in 1.The efficacy had a close relationship with the strength of the tibialis posteior,condition of the patients such as deformity and contracture of achilles tendon,and methods of operation.Based on the analysis of the effects of operation,the interosseous method was superior to subcutaneous method.We found that some patients plantar arches became flat after operation.For this reason,we selected 4 cases to take out the paralytic pretibial muscle,fix its distal terminal to the terminal point of tibialis posterior and its proximal to the gastrocnemius muscle.The author modified the procedure for case of olisthe of the tendon after operation.Conclusion The interosseous method is superior to the subcutaneous method. ......
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