脑瘫常见足踝畸形.pdf

脑瘫常见足踝畸形及处理 厦门市妇幼保健院 冯林 脑瘫 • Cerebral palsy(CP) describes a group of permanent disorders o f the development of movement and posture, causing activity li mitation, that are attributed to nonprogressive disturbances tha t occurred in the developing fetal or infant brain. The motor dis orders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication, and behavi or, by epilepsy, and by secondary musculoskeletal problems. Rosebaum P, Paneth N, Leviton A. et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol 2007; 49(Suppl 109):8-14 脑瘫 足踝畸形常见于脑瘫患儿，发生率高达93 ％ O’Connell PA, D’Souza L, Dudeney S, Stephens M. Foot deformities in children with cerebral palsy. J PediatrOrthop 1998; 18:743 – 747. 脑瘫足踝畸形 跖屈 踝关节 跟行 内翻 后足 外翻 足踝畸形 高弓 中足 塌陷 内收 前足 外展 脑瘫足踝畸形的处理 • 方法选择 牵拉，肌张力控制，支具，手术 • 目的 改善步态，提高效率 • 手术原则 重建关节，矫正骨性畸形和平衡肌力 AFO 常见足踝畸形 • 跖屈（Equinus ） • 跖屈内翻（Equinovarus ） • 足外翻（Planovalgus ） • 胫骨旋转 跖屈畸形(Equinus) 跖屈畸形 • 脑瘫最常见的畸形 • 胫前肌无力 • 小腿三头肌痉挛/ 挛缩 • 孤