Ilizarov外固定架非对称性延长一期治疗股骨短缩合并重度膝外翻畸形

发布时间：2018-08-31 15:38

【摘要】：[目的]探讨运用Ilizarov外固定架非对称性延长术一期治疗严重膝外翻畸形合并股骨短缩的疗效,为临床选择合理的治疗方法提供依据。[方法]回顾性分析本院儿童骨科2006年1月~2015年4月采用Ilizarov外固定架对12例膝外翻畸形并肢体短缩患者行Ilizarov外固定架延长术治疗的资料。男4例,女8例,年龄13~21岁,平均16.5岁,均为单侧。术前患侧肢体短缩6~11 cm,平均8.40 cm;股胫角155°~135°,平均142°;踝间距15~43cm,平均28.20 cm。通过Paley法确定膝外翻矫形截骨平面(远端),根据截骨处骨质情况确定是否需要股骨近段截骨来延长股骨。本组病例均行单一股骨远端截骨Ilizarov外固定架非对称性延长术。[结果]全部患者均获随访。随访时间12~60个月,平均34个月,延长范围6~10 cm,平均7.90 cm。愈合后股胫角161°~169°,平均166°,患肢术后短缩-0.80~1.20 cm,平均0.30 cm,膝外翻及股骨短缩纠正满意,行走无疼痛,无骨不连及腓总神经损伤发生,术后有10例患儿出现膝关节伸屈受限,伸(0°)~屈(15°~90°),经过理疗锻炼后明显好转,达到伸(0°)~屈(60°~105°)。[结论]Ilizarov外固定架非对称性延长术一期治疗严重膝外翻畸形合并股骨短缩具有截骨愈合好、创伤小及并发症少等优点,是一种有效、可靠的方法。
[Abstract]:[objective] to investigate the efficacy of Ilizarov external fixator in the treatment of severe genu valgus deformity with femoral shortening in one stage, and to provide the basis for clinical selection of reasonable treatment methods. [methods] the data of 12 cases of knee valgus deformity and limb shortening treated with Ilizarov external fixator from January 2006 to April 2015 in pediatric orthopedic department of our hospital were analyzed retrospectively. Male 4 cases, female 8 cases, age 13 to 21 years old, average 16.5 years old, are all unilateral. Preoperative shortening of the affected limbs averaged 8.40 cm; for 611 cm, 155 掳for tibial angle, 142 掳for average, and 1543 cm for ankle spacing, with an average of 28.20 cm.. The Paley method was used to determine the osteotomy level (distal end) of genu valgus and to determine whether proximal femur osteotomy was needed to prolong the femur according to the bone condition of the osteotomy. All the patients underwent asymmetric lengthening with Ilizarov external fixator of single distal femur osteotomy. [results] all patients were followed up. The follow-up time was 12 ~ 60 months (mean 34 months), and the extension range was 6 ~ 10 cm, with an average of 7.90 cm.. After healing, the femoral tibial angle was 161 掳to 169 掳, with an average of 166 掳. The knee varus and femur shortening were corrected with satisfactory results at an average of 0.30 cm, (-0.80 卤1.20 cm,). There was no pain in walking, no bone nonunion and no injury to the common peroneal nerve. There were 10 cases with limited knee extension and flexion after operation. Extension (0 掳) ~ flexion (15 掳~ 90 掳), after physiotherapy exercise, obviously improved to (0 掳) ~ (60 掳) (60 掳~ 105 掳). [conclusion] Ilizarov external fixator asymmetric lengthening is an effective and reliable method for the treatment of severe genu valgus deformity with short femoral contraction, which has the advantages of good healing, less trauma and less complications.
【作者单位】：第四军医大学西京医院骨科;
【基金】：国家自然科学基金资助项目(编号:81171735)
【分类号】：R687.3

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