先天性跟骨外翻足

Congenital Talipes Calcaneovalgus: A Case Report

陳瓊英(Chiung-Ying Chen)

《職能治療學會雜誌》 16卷 (1998/09) Pp. 65-71

https://doi.org/10.6594/JTOTA.1998.16.06

摘要

先天性跟骨外翻足的特徵是足部背屈及足外翻，足背及其外側的軟體組織較緊縮，足部蹠屈及足內翻則有角度上的限制。嚴重者足部可以碰到小腿的背側。造成跟骨外翻足的原因可能是由於胎兒在子宮中不正常的姿勢所致(Tachdjan,1990)。本文是關於一位先天性跟骨外翻足的嬰兒，出生十一天就開始接受爲期近二十五周的職能治療〔其中四周缺席〕。職能治療包括：（一）為其腳踝附近做按摩、被動牽拉運動；（二）製作足部矯正副木並定期修改；（三）指導家人正確穿戴副木的方法及注意事項；（四）教導並定期示範居家運動。由於個案的母親在懷孕期間患有子宮肌瘤，故回顧文獻瞭解子宮肌瘤與出生嬰兒的先天性跟骨外翻足的關係，結果並未發現有直接的關係。治療的結果令人滿意，其患足和健足並無明顯的差異。雖然如此，本篇個案報告仍有多處待改進的地方。

關鍵字

先天性跟骨外翻足 ； 矯正副木 ； 職能治療

並列摘要

Talipes calcaneovalgus is characterized by the dorsiflexion and eversion of the involved foot. The soft tissues on the dorsal and lateral sides of the ankle are tight and also limit plantarflexion and inversion. In severe cases, the foot may touch the anterial tibia. Talipes calcaneovalgus is caused by the intrauterine malposture. In the case report, an 11 days old infant with congenital talipes calcaneovalgus received about 25-week occupational therapy, including 4-week absence. Occupational therapy provided the following services for his foot deformity: (1) performing massage and stretch for his involved foot; (2) fabricating and periodically correcting his foot splint; (3) instructing his care giver correct splinting procedures and precautions; (4) periodically demonstrating home exercise programs. Because the mother was found uterine leiomyomata during her pregnancy, literature review was performed to understand the relationship between uterine leiomyomata of the pregnant woman and the talipes calcaneovalgus of the newborn infant. No direct relationship was found. The result of occupational therapy was satisfactory. There was no significant difference between his involved foot and normal one at discharge. Even though, this case report still included many limitations.

並列關鍵字

congenital talipes calcaneovalgus ； splinting ； occupational therapy