先天性跟骨外翻之職能治療

Occupational Therapy for Congenital Calcaneovalgus Deformities

施鍏麒(Wai-Kei Sze)

《職能治療學會雜誌》 7卷 (1989/12) Pp. 89-95

https://doi.org/10.6594/JTOTA.1989.07.09

摘要

先天性跟骨外翻是新生兒最常見的姿勢畸形之一。原因可能是胎兒足部發展完成後，在子宮內被固定在不良姿勢所致。許多學者認為此畸形在出生後不久會有所改善，對於輕微的病患只建議父母替小孩做被動運動。臨床上，較嚴重的病患，則給予踝足副木矯治此畸形，踝足副木的功能主要是使踝關節能維持在不內旋亦不外旋的正中位置。中度的跟骨外翻，踝關節只需要維持在90度，較嚴重的則要稍微蹠曲5-10度以達拉張前背側的軟組織與背屈腱之功用，防止踝關節因背屈腱的長期繃緊而造成孿縮。適當的使用踝足副木不但可以減輕畸形程度，且能使足部保持在良好姿勢下均匀地發育。一般而言，有接受治療者，在出生後不到4個月內就有所改變，乃因新生兒的足部具有彈性，愈早治療預後愈好。

並列摘要

Congenital calcaneovalgus is a very common postural deformity of the neonate. The etiology is assumed to be ”in utero packing” caused by fetal positioning within the womb. Some authors think that this ”packaging” defect will be improve spontaneously after birth. In most cases with lesser degrees of deformity, passive exercises alone are sufficient. Clinical treatment is recommended for those cases that are unusually resistant. Treatment of this deformity is best done with below knee Ankle-Foot corrective orthosis (AFO) holding the ankle in neutral position (with neither inversion nor eversion) and slight plantar flexion. For those cases that are less resistant, the ankle is kept at right angle instead of slight plantar flexion. Proper use of a well-fitted AFO can alleviate this deformity and keep the foot in good alignment. The created feet usually will correct within 2 to 4 months. Since an infants feet are ”flexible”, early treatment gives best results.

並列關鍵字

calcaneovalgus deformity ； Ankle-Foot Orthosis ； occupational therapy