兒童扁平足病因、檢測(cè)方法和治療現(xiàn)狀

　　摘   要：扁平足在兒童中常見(jiàn)，特別是學(xué)齡前兒童。迄今為止扁平足仍沒(méi)有標(biāo)準(zhǔn)的定義，一般認(rèn)為，扁平足的形成與足部骨結(jié)構(gòu)異常或肌肉韌帶松弛導(dǎo)致內(nèi)側(cè)縱弓塌陷有關(guān)。扁平足一般情況下是生理性的，表現(xiàn)為柔韌性扁平足，絕大部分隨著年齡的增加癥狀會(huì)逐漸得到改善。在罕見(jiàn)的情況下，扁平足也可能是病理性的，表現(xiàn)為僵硬性扁平足，如先天性垂直距骨、跗骨聯(lián)合等。隨著生物力學(xué)的不斷發(fā)展，扁平足的檢測(cè)及評(píng)估不僅包括簡(jiǎn)單的足印分析和X射線平片，還包括足底壓力測(cè)試、三維激光掃描等，大大提高了檢測(cè)及評(píng)估的準(zhǔn)確率及效率。在治療方面，雖然目前暫沒(méi)有大型的前瞻性研究肯定保守治療的療效，也不能通過(guò)現(xiàn)有的檢測(cè)及評(píng)估方法確定哪些患者即使在成年后仍不能緩解疼痛及畸形，但根據(jù)生物力學(xué)制定的矯形器械如鞋墊等在緩解扁平足的疼痛、改善步態(tài)方面確有一定作用。手術(shù)的療效是值得肯定的，手術(shù)治療扁平足主要從軟組織、截骨術(shù)、關(guān)節(jié)融合、關(guān)節(jié)制動(dòng)術(shù)等方面選擇或聯(lián)合，效果良好，需嚴(yán)格掌握手術(shù)適應(yīng)證和禁忌證。
　　關(guān)鍵詞：兒童;扁平足;發(fā)育;病理生理;檢測(cè);評(píng)估
　　中圖分類號(hào)：R726.8                                 文獻(xiàn)標(biāo)識(shí)碼：A                                 DOI：10.3969/j.issn.1006-1959.2018.05.020
　　文章編號(hào)：1006-1959（2018）05-0056-06
　　The Cause，Detection Method and Treatment Status of Children"s Flat Foot
　　GUO Peng，LUO Cong
　　（Department of Orthopaedics，Room One，Children"s Hospital，Chongqing Medical University，Chongqing 400000，China）
　　Abstract：Flat feet are common in children，especially preschool children.So far there is no standard definition of flat feet，generally believed that the formation of flat feet and foot bone structure or muscle ligament relaxation causes the medial longitudinal arch collapse related.Flat feet are generally physiological，showing a flexible flat foot，and most of the symptoms gradually improve with age. In rare cases，the flat foot may also be pathological，showing a rigid flat foot，such as congenital vertical talus，zygomatic unity.With the continuous development of biomechanics，the detection and evaluation of flat feet not only include simple footprint analysis and X-ray film，but also include plantar pressure testing and three-dimensional laser scanning，which greatly improves the accuracy and efficiency of detection and evaluation.In terms of treatment，although there is currently no large-scale prospective study confirming the efficacy of conservative treatment，it cannot be determined through existing tests and assessments which patients do not relieve pain and deformity even after adulthood，but according to biomechanics orthopaedics Instruments such as insoles have a certain role in relieving flat foot pain and improving gait.The efficacy of the surgery is worthy of recognition.Surgical treatment of flat feet is mainly selected from the aspects of soft tissue，osteotomy，arthrodesis，etc.The effect is good，and surgical indications and contraindications need to be strictly controlled.

相關(guān)熱詞搜索：扁平足 病因 檢測(cè)方法 現(xiàn)狀 兒童