[目的]探讨注射A型肉毒毒素结合跟腱延长对痉挛型脑瘫马蹄足畸形的治疗作用。[方法]选择15例痉挛型脑瘫马蹄足畸形患儿采用电刺激引导下局部肌肉注射A型肉毒毒素,注射后9~14 d行跟腱延长术,术后石膏固定6周,拆除石膏后康复训练。观察治疗前、治疗后7 d及6个月病变下肢肌张力、痉挛状态及踝关节的功能改变。[结果]单纯肉毒素治疗后,跟腱挛缩有所改善,但仍遗留部分马蹄畸形,跟腱延长术后6个月马蹄畸形仍持续改善,踝关节被动活动仍维持在背屈5°~12°(平均7.6°±2.5°),行走步态较前明显改善,未出现屈肌张力不够的步态不稳。[结论]对于部分年龄较大、挛缩程度较重存在固定性挛缩的痉挛型脑瘫马蹄畸形的患儿,在注射A型肉毒毒素的同时结合跟腱延长术,疗效更为满意。 [Objective] To explore the therapeutic effect of botulinum toxin type A injection combined with Achilles tendon extension on spondylolisthesis of clubfoot deformity. [Method] Fifteen children with spastic cerebral palsy clubfoot were injected with local injection of botulinum toxin type A under the guidance of electrical stimulation. Achilles tendon was extended from 9 to 14 days after injection. The gypsum was fixed for 6 weeks after the plaster was removed Rehabilitation. The changes of lower extremity muscle tone, spasticity and ankle joint function were observed before treatment, 7 days and 6 months after treatment. [Result] After the treatment of simple botulinum toxin, the Achilles tendon contracture was improved, but some horseshoe deformity still remained. The Horseshoe deformity continued to improve 6 months after Achilles tendon extension, and the passive ankle joint activity remained at 5 ° ~ 12 d ° (7.6 ° ± 2.5 ° on average). The walking gait improved obviously compared with the former, and there was no unsteady gait with insufficient flexor tension. [Conclusion] For children with spastic cerebral palsy horseshoe deformity who have a certain degree of contracture and severe contracture, they are more satisfied with the injection of botulinum toxin type A combined with Achilles tendon extension.