[1]吕秉舒,田亚敏,李东升,等.带血管腓骨翻转内固定联合胫骨微创截骨Ilizarov骨延长术治疗先天性胫骨假关节[J].中医正骨,2020,32(06):65-68.
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带血管腓骨翻转内固定联合胫骨微创截骨Ilizarov骨延长术治疗先天性胫骨假关节()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年06期
页码:
65-68
栏目:
临床报道
出版日期:
2020-06-20

文章信息/Info

作者:
吕秉舒; 田亚敏; 李东升; 吕秉乐
(河南省洛阳正骨医院河南省骨科医院,河南洛阳471002)
关键词:
下肢畸形; 先天性;  胫骨假关节;  截骨术;  骨延长术;  伊利扎罗夫技术
摘要:
目的:观察带血管腓骨翻转内固定联合胫骨微创截骨Ilizarov骨延长术治疗先天性胫骨假关节的临床疗效及安全性。方法:2010年1月至2017年12月,采用带血管腓骨翻转内固定联合胫骨微创截骨Ilizarov骨延长术治疗先天性胫骨假关节患者21例,男9例、女12例; 年龄6～14岁,中位数11岁; 初次手术20例,经4次手术后病情复发1例; 均有患肢成角短缩畸形。术后随访观察患肢畸形矫正、长度恢复、功能恢复以及并发症发生情况。结果:本组患者均获随访,随访时间18～42个月,中位数32个月。胫骨骨延长2.10～13.20 cm,中位数8.00 cm。拆除外固定架时间18～36个月,中位数28个月。调整外固定架次数为4～12次,中位数8次。截骨处骨折均愈合。胫骨近端外翻角,术前12.62°±4.80°、末次随访3.33°±1.20°; 踝关节外翻角,术前15.48°±4.68°、末次随访4.57°±2.62°; 双侧胫骨长度差,术前(9.10±3.55)cm、末次随访(1.49±0.55)cm; 下肢功能评价量表评分,术前(48.20±4.33)分、末次随访(75.33±3.71)分。2例出现再骨折,给予二次手术后骨折愈合; 2例出现跟腱短缩、1例出现膝关节屈曲畸形,经康复锻炼后均好转; 1例出现胫骨前侧切口脂肪液化开裂,经多次换药后切口愈合; 所有患者均未出现血管神经损伤和骨髓炎。结论:采用带血管腓骨翻转内固定联合胫骨微创截骨Ilizarov骨延长术治疗先天性胫骨假关节,可矫正患肢畸形、恢复患肢长度、促进患肢功能的恢复,且并发症较少,值得临床推广应用。

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备注/Memo

备注/Memo:
(收稿日期:2020-02-24本文编辑:时红磊)通讯作者:吕秉乐E-mail:5553793@qq.com
更新日期/Last Update: 2020-10-10