the horseshoe varus foot ( talipes equinovarus) Is one of the most common congenital clubfoot, which accounts for about 77% of congenital foot deformity. The horseshoe varus foot deformity by foot drop, in turn, adduction of three kinds of factors. Patients can be accompanied by other malformations, congenital dislocation of the hip, and refers to, muscular torticollis, etc. This can cause children was born, found that most timely treatment, curative effect is better.
congenital horseshoe varus foot causes this disease?
1。 After long-term weight foot dorsal thickening slippery bursa and callosity, a handful of ulcer.
2。 The patient’s postoperative complications mainly has the following some performance:
( 1) Postoperative pain: for the children because of the cerebral cortex of postoperative fully awake pain response affected by the psychological state of tension, anxiety, fears are lower the pain threshold.
( 2) Pressure ulcers: children with congenital horseshoe varus foot due to lack of exercise in bed for a long time, lead to all parts of body blood circulation is poor, compression parts easy to cause pressure sores.
( 3) Limb ischemic necrosis or contracture: its early performance mainly limb pale color, material temperature is reduced, skin feel dull, not their activities or local persistent pain, the plaster bandage should be opened to avoid limb ischemic necrosis or muscle contracture.
how to prevent the horseshoe varus foot complications?
the horseshoe varus deformity recurrence was the cause of foot complications, for once the nationalisation of the deformity correction, but in the process, appear deformity appeared again, orthopaedic use bad, is the main reason.
initial deformation extent, may also be associated with recurrence of deformities. The early detection of recurrent deformity, can try to plaster orthopaedic again, part of the gypsum orthopaedic failure cases, soft tissue release the operation, close to stop stage in growth, using the osseous orthopaedic surgery.
second, is excessive orthopaedic, sufficient evaginate in the inside of the soft tissue release after postoperative relatively common, often accompanied by joint relaxation, the orthopedic challenging, rocking chair foot deformities often after non-operative treatment is relatively common, mainly because of elbow is not fully reset, extremely powerful dorsiflexion ankle, joint processing technique needs to be reset from the week, then cut off or extension of the Achilles tendon surgery again.
the third, it is the residual deformities, through various means are completed can’t correct the deformity, common in heel and forefoot adduction, the reason is not clear, the horseshoe varus deformity sex foot children see more, modification is difficult.
4, is powerless, triceps weakness will affect activity function, excessive extension and repeatedly extended tendon surgery, have increased the risk of complications.
the fifth, it is other complications, about 30% of the water chestnut varus foot children, visible dynamic supination deformity, step by step for children older than three to four years, may need to have it into the top offset muscle, unilateral horseshoe varus foot of children, need to tell the lesions, including foot and leg.
6, is stiff, the inside of the soft tissue release after surgery is relatively common, may be associated with surgical scar contracture, clinical treatment difficult.
as a result, in future, the calf and foot, compared with the contralateral, thin and short.
the horseshoe varus foot how to prevent the complications, for gypsum oppression, formation pressure ulcers: a plaster cast, bone protruding points with skimmed pads, but shoulds not be too thick so as not to affect to record straight effect, gypsum type tube has not been solidified in shaping, avoid by all means with finger pressure, gypsum after drying, should be timely medical treatment, cheek bone observation window.
prevent local skin necrosis, extend the tibialis posterior, flexor long and long hallux flexor tendon of the medial incision with Achilles tendon to extend incision, skin flap to compare between the two incision to ischemic necrosis. Precaution: soft tissue jieshou preoperative, often massage the foot inside the skin, promote blood circulation, secondly the Achilles tendon extended as far as possible to the Achilles tendon and longitudinal axis of the lateral incision, an arc incision.
calf greenstick fracture or ankle epiphyseal separation, technique level, should be gradual, press gently, not too hard and second assistant in close coordination with the performer, in case of an accident.