摘要目的 观察自行研制的渐进性U型低温矫形器矫治创伤性足下垂畸形的效果. 方法 回顾性分析2011年4月至2014年5月35例胫骨行环式外固定支架固定术后因伤创等因素并发足下垂畸形且应用自行研制的渐进性U型低温矫形器进行矫治的患者资料,男28例,女7例;年龄16～65岁,平均34.0岁;右侧16例,左侧19例.矫治前均有轻至中度的垂足畸形,佩戴渐进性U型低温矫形器进行矫治.通过比较足踝矫治前、矫治后6个月及末次随访时背屈、跖屈、内翻、外翻的角度及视觉模拟评分(VAS)观察矫治效果.结果 28患者术后获10 ～ 25个月(平均16.1个月)随访.末次随访时的背屈、跖屈、内翻、外翻的角度和VAS评分与矫治前比较,差异均有统计学意义(P＜0.05).末次随访时的背屈、跖屈、外翻的角度和VAS评分与矫治后6个月比较,差异均有统计学意义(P＜0.05).矫治后6个月的背屈、外翻的角度和VAS评分与矫治前比较,差异均有统计学意义(P＜0.05).3例患者因损伤严重、年龄、依从性差等因素矫治效果不明显.28例患者中均无出现压疮、血管神经损伤和严重的足下垂畸形并发症. 结论 自行研制的渐进性U型低温矫形器矫治胫骨环式外固定支架术后出现的足下垂畸形,是个安全、行之有效的方法.

abstractsObjective To evaluate our self-developed static U-shape orthosis which stretches progressively in a low temperature for treatment of posttraumatic equinus contracture in patients who underwent tibial ring external fixation.Methods From April 2011 to May 2014,a ring external fixator was used to treat 35 patients with tibial bone defect,infectious nonunion or osteomyelitis.They were 28 males and 7 females,aged from 16 to 65 years (average,34.0 years).The left side was affected in 16 and the right side in 19 cases.There were 27 open tibial fractures and 8 closed tibial fractures with postoperative infection.Their mild to moderate posttraumatic equinus contracture was corrected with our static U-shape orthosis which stretched progressively in a low temperature.The efficacy was evaluated by comparing dorsal flexion,plantar flexion,varus and valgus of the ankle and the visual analogue scale (VAS) scores before correction,6 months after correction,and at the last follow-up.Results The 28 patients were followed up for 10 to 25 months (average,16.1 months) postoperation.The dorsal flexion,plantar flexion,varus and valgus of the ankle and the VAS scores at the last follow-up were significantly improved compared with those before correction (P ＜ 0.05).The dorsal flexion,plantar flexion,varus and valgus of the ankle and the VAS scores at the last follow-up were also significantly improved compared with those at 6 months after correction (P ＜ 0.05).The dorsal flexion,plantar flexion,varus and valgus of the ankle and the VAS scores at 6 months after correction were also significantly improved compared with those before correction (P ＜ 0.05).Three cases did not respond well to the correction due to injury severity,age,or poor compliance.There were no reports of numbness or skin problems.Conclusions Our self-developed static U-shape orthosis which stretches progressively in a low temperature has proved to be a safe and effective ancillary correction of the posttraumatic equinus contracture in patients undergoing tibial ring external fixation.