临床外科杂志 ›› 2026, Vol. 34 ›› Issue (4): 364-368.doi: 10.3969/j.issn.1005-6483.20260387

• 专家笔谈 • 上一篇    下一篇

外固定足踝畸形矫正:原理、原则及方法

李霁云 乔碧玄 邹达西 臧建成   

  1. 100029北京,北京中医药大学第三附属医院手足与矫形外科,“中医骨伤治疗与运动康复智能化”教育部工程研究中心
  • 收稿日期:2026-04-30 出版日期:2026-06-08 发布日期:2026-06-08
  • 通讯作者: 臧建成,Email:Jianch88@aliyun.com
  • 基金资助:
    北京市自然科学基金资助项目(L252118)

External fixation in foot and ankle deformity correction:principles,guidelines and methods

LI Jiyun,QIAO Bixuan,ZOU Daxi,ZANG Jiancheng   

  1. Department of Hand,Foot and Orthopaedic Surgery,Beijing University of Chinese Medicine Third Affiliated Hospital,Engineering Research Center of Intelligentization of Traditional Chinese Medicine Orthopedics and Sports Rehabilitation,Ministry of Education,Beijing 100029,China
  • Received:2026-04-30 Online:2026-06-08 Published:2026-06-08

摘要: 足踝作为人体承重与行走的核心功能单元,其结构精细、功能复杂。足踝畸形常由骨骼、肌肉、肌腱以及神经血管的障碍所致,其矫正需兼顾形态重建与动态功能平衡,外固定技术以其微创、可调、组织再生等优势,成为复杂足踝畸形治疗的重要手段。本文系统阐述外固定矫正足踝畸形的核心原理——基于“张力-应力法则”的组织牵拉再生与应力控制,以及衍生的三大治疗原则:以跖行足为目标的整体平衡原则、以畸形顶点为导向的个性化构型原则以及“时间维度”参与的序贯调控原则。本文重点论述外固定足踝畸形矫正的原理和原则,截骨术和软组织平衡术在畸形矫正中的关键作用,系统介绍软组织牵张矫正、截骨矫形以及Ilizarov外固定器的临床应用策略,特别针对不同病因足踝畸形的治疗特点进行分类阐述,强调了外固定-矫形器-矫形鞋垫序贯治疗模式及规范化术后康复流程的重要性,在秦泗河自然重建理念、Ilizarov技术、Paley矫形外科原则以及中医筋骨理论基础上形成的外固定足踝矫形策略为临床规范化应用提供参考,是确保疗效的重要基础。

关键词: 外固定, 足踝畸形, 自然重建理念, Ilizarov技术, 软组织平衡, 序贯治疗, 筋骨理论

Abstract: As the core functional units of weight-bearing and walking in the human body,the foot and ankle possess intricate structures and complex functions.Foot and ankle deformities often result from disorders of bones,muscles,tendons,and neurovascular structures.Their correction requires attention to both morphological reconstruction and dynamic functional balance.External fixation,with its advantages of minimal invasiveness,adjustability,and tissue regeneration,has become an important treatment modality for complex foot and ankle deformities.This article systematically elaborates the core principles of external fixation for correcting foot and ankle deformities-tissue distraction and regeneration based on the tension-stress principle along with stress control,as well as three derived treatment principles:the overall balance principle targeting a plantigrade foot,the individualized configuration principle guided by the apex of deformity,and the sequential regulation principle involving the time dimension.The article focuses on discussing the principles of external fixation for foot and ankle deformity correction,and the key roles of osteotomy and soft tissue balancing procedures in deformity correction.It systematically introduces clinical application strategies for soft tissue distraction correction,osteotomy and orthoplasty,and the Ilizarov external fixator.Treatment characteristics for foot and ankle deformities of different etiologies are specifically categorized and elaborated.The importance of the sequential treatment model of external fixation-orthosis-orthopedic insole and standardized postoperative rehabilitation is emphasized.The external fixation strategy for foot and ankle orthopedics,developed on the basis of Qin Sihe's concept of natural reconstruction,the Ilizarov technique,Paley's principles of orthopedic surgery,and traditional Chinese medicine theory of tendons and bones,provides a reference for standardized clinical application and serves as an important foundation for ensuring treatment efficacy.

Key words: external fixation, foot and ankle deformity, natural reconstruction concept, Ilizarov technique, soft tissue balance, sequential treatment, theory of sinew and bone

[1] 商帅 宋宁泽 约日古丽·艾微拉 李楠. 外固定支具配合下肢康复机器人系统对创伤性下肢骨折病人骨折愈合及功能恢复的影响[J]. 临床外科杂志, 2026, 34(4): 395-400.
[2] 郝光亮, 张强, 谷铭勇, 张贵春, 张永先, 曹学成, 蔡锦方. 微型外固定架联合前臂骨间背皮瓣修复重度虎口挛缩的疗效观察[J]. 临床外科杂志, 2019, 27(5): 429-432.
[3] 廖琦 刘世清 陈庆 贺斌. 外固定支架加植骨治疗胫骨骨折术后骨不连22例分析[J]. 临床外科杂志, 2012, 20(6): 428-428.
[4] 周庞虎 邱波 刘世清等. 肢体严重开放性骨折的急诊处理与临床疗效分析[J]. 临床外科杂志, 2012, 20(10): 730-731.
[5] 郭亚洲 徐辉 郑均华 万昌涛 钱苏林 曾舸. 有限内固定结核铰链式超关节外固定架治疗肱骨远端复杂骨折[J]. 临床外科杂志, 2012, 20(1): 63-63.
[6] 高艳峰 陶凤华 卫爱玲 甘奇. 桡骨远端不稳定骨折44例治疗分析[J]. 临床外科杂志, 2011, 19(10): 717-717.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!