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《中华骨与关节外科杂志》2015年8月 第8卷 第4期Chinese Journal of Bone and Joint Surgery Vol.8, No.4Aug 2015*通信作者：秦泗河，E-mail：qinsihe@163.com? 临床论著 ?文章编号：2095-9958（2015）08--04DOI：10.3969/j.issn.2095-9958.2015.04-008Ilizarov技术治疗下肢血管瘤致足踝畸形焦绍锋1秦泗河1*王振军1郭保逢2邵波1潘奇1臧建成1（1.国家康复辅具研究中心附属康复医院矫形骨科，北京 100176；2.北京市垂杨柳医院矫形骨科，北京 100022）背景：下肢血管瘤继发的骨关节畸形以足踝部畸形最多见，采用传统方法手术松解，不仅易损伤血管瘤引起出血，而且对于挛缩较重的患者难以进行彻底矫正。目的：探讨Ilizarov技术治疗下肢血管瘤继发足踝畸形的临床疗效。方法：2005年5月至2013年12月，我院共收治血管瘤致足踝畸形患者24例，男14例，女10例；年龄6~26岁，平均22岁；马蹄足畸形14例，马蹄内翻足畸形6例，马蹄高弓足畸形4例。所有患者在接受有限矫形手术后安装Ilizarov足踝牵伸矫形器；伴有屈膝挛缩畸形者，同时安装膝关节牵伸器。术后5~7 d开始牵拉矫正踝足畸形，牵伸治疗期间，可以扶双拐下地，术肢轻负重行走。末次随访时采用足踝ICFSG评分评估治疗效果。结果：24例患者均获随访，随访时间6~40个月，平均18个月。所有患者畸形均矫正，恢复跖行足。牵拉矫形时间7~35 d，平均23 d。末次随访时足踝ICFSG评分结果：优14例，良6例，一般4例，差0例，优良率为83.3%。结论：小腿及踝足部的海绵状血管瘤可引起足踝部的畸形，以马蹄足、马蹄内翻足及马蹄高弓足多见。微创挛缩软组织松解后采用Ilizarov技术缓慢牵拉矫正下肢血管瘤所致的足踝部畸形，可避免开放手术引起的出血风险，取得满意疗效。关键词：血管瘤；足踝畸形；Ilizarov技术Ilizarov technique for foot and ankle deformities secondary tolower limb hemangiomaJIAO Shaofeng1, QIN Sihe1*, WANG Zhenjun1, GUO Baofeng2, SHAO Bo1, PAN Qi1, ZANG Jiancheng1(1.Department of Orthopaedics,Affiliated Hospital of National Research Center for Rehabilitation TechnicalAids,Beijing 100176; 2.Department of Orthopaedics, Beijng Chuiyangliu Hospital, Beijing 100022, China)Background: Foot and ankle deformity is most common in osteoathropathy secondary to lower limb hemangioma. Tradition-ally, releasing the contracture soft tissue was used to correct this kind of deformity, which is not only easy to injure the hem-angioma and lead blooding, but also hard to totally correct the severe deformities because of the soft tissue limit.Objective: To investigate clinical outcomes of Ilizarov technique for foot and ankle deformities caused by lower limb hem-angioma.Methods: A total of 24 patients with foot and ankle deformities secondary to lower limb hemangioma treated in our hospitalfrom May 2005 to December 2013 were enrolled in this retrospective study. There were 14 males and 10 females with amean age of 22 years old (range, 6-26 years). There were 14 equinus, 6 equinovarus and 4 equinocavus. All the patients un-derwent limited surgery firstly and then Ilizarov technique was used to correct residual deformities. If knee contracture coex-isted, a special apparatus was installed on the knee. Residual deformities were corrected by Ilizarov fixator 5 to 7 days aftersurgery. During the treatment period, patients can walk with the help of crutches. ICFSG scoring system was used to evalu-ate therapeutic effect at the final follow-up.Results: The mean duration of follow-up was 18 month in the 24 patients (range, 6-40 months). All deformities were totallycorrected and plantigrade feet obtained. The mean treatment time by Ilizarov fixator was 23 days (range, 7-35 days). The re-sult of the treatments was excellent in 14 feet, good in 6 feet, fair in 4 feet according to ICFSG scoring system.Conclusions: Lower limb hemangioma can lead to foot and ankle deformities in which equinus, equinovarus and equinoca-vus are very common. Minimally invasive soft tissue releasing procedure combined with Ilizarov technique can reduce therisk of bleeding during the surgical procedure and the therapeutic effect is satisfactory.Key words: Hemangioma; Foot and ankle deformity; Ilizarov technique0310