陈瑞巧　梁燕清　李玉红

【摘要】 目的 探讨生长发育期儿童扁平足的分析及手法矫治的临床效果。方法 72例（137只）扁平足患儿， 根据治疗方法分为观察组（36例， 69只）和对照组（36例， 68只）。观察组实施手法矫治， 对照组实施功能锻炼。比较不同年龄扁平足发生率以及两组临床疗效。结果 115例（230只）足中扁平足137只， 发生率为59.57%。男童发生率为59.17%， 女童发生率为60.00%， 比较差异无统计学意义（P>0.05）；扁平足4岁发生率为68.52%， 5岁发生率为59.17%， 6岁发生率为51.79%， 各年龄发生率比较差异具有统计学意义（P<0.05）；4～6歲儿童扁平足发生率随年龄增加呈递减趋势。观察组治疗优良率为85.51%， 高于对照组的54.41%， 差异具有统计学意义（P<0.05）。结论 扁平足在儿童中发生率高， 随着年龄增加、发育成熟部分儿童逐渐趋于正常， 手法矫治可促进足底血液循环从而矫正跖骨外展、骨外翻等情况， 疗效显著， 值得临床推广应用。

【关键词】 扁平足；儿童；足弓；手法矫治

DOI：10.14163/j.cnki.11-5547/r.2017.18.016

【Abstract】 Objective To investigate analysis and clinical effect by manipulation correction for children flatfoot at growth and development period. Methods A total of 72 children patients with flatfoot were divided by their treatment measures into observation group （36 cases， 69 feet） and control group （36 cases， 68 feet）. The observation group received manipulation correction， and the control group received functional training. Comparison was made on incidence of flatfoot in patients with different ages， and clinical effects between the two groups. Results There were 137 feet with flatfoot among 115 cases （230 feet）， with incidence as 59.57%. Incidence of flatfoot was 59.17% in male children and 60.00% in female children， and their difference had no statistical significance （P>0.05）. Incidence of flatfoot was respectively 68.52% in 4-year-old children， 59.17% in 5-year-old children and 51.79% in 6-year-old children. Their difference of incidence between each two age period had statistical significance （P<0.05）. Along with increasing age， incidence of flatfoot in children aging 4～6 years old showed a decline trend. The observation group had higher good rate in treatment as 85.51% than 54.41% in the control group， and the difference had statistical significance （P<0.05）. Conclusion Flatfoot shows high incidence in children， and it tends to be normal along with increasing age and maturation. Manipulation correction can promote plantar blood circulation and correct metatarsal abduction and ectropion with excellent effect， and this method is worth clinical promotion and application.

【Key words】 Flatfoot； Children； Arches of the foot； Manipulation correction

足为下肢最远端器官， 起着支撑体重和力量传递的作用。据统计， 约80%的人在一生中会出现不同种类的足病[1]， 而扁平足为其中较常见的疾病， 以足弓塌陷或消失为特点， 对患儿的生活造成了影响。儿童和青少年为扁平足的高发人群， 特别是儿童， 发病率达60%以上[2]， 扁平足的治疗不可完全依赖手术或药物治疗， 尤其是儿童的身体可塑性强， 通过足部矫形器、手法矫治等可达到矫正目的。

1 资料与方法

1. 1 一般资料 采用静态足底压力测试器于2015～2016年对本中心的115例（230只）儿童进行足底检查， 共检测出72例（137只）扁平足， 其中男40例（71只）， 女32例（66只）， 年龄4～6岁， 4岁19例（37只）， 5岁38例（71只）， 6岁15例（29只）。根据治疗方法分为观察组（36例， 69只）和对照组（36例，

68只）。

1. 2 测试方法 患儿双足并列站立在测试仪器上， 全身放松， 采集静态足底压力图像。分别测试足前、中、后部三部分压力， 计算足中部内侧与总中部整体压力比值， 若比值>24%则判定为扁平足[3]。