Gladbach B, Pfeil J, Heijens E
OKW, Orthopädische Klinik Wiesbaden.
Orthopade. 2000 Jan;29(1):2-8. doi: 10.1007/s001320050002.
The percutaneous epiphysiodesis is recommended as a save and reliable technique. We have performed 21 distal femoral, 17 proximal tibial and 3 proximal fibular percutaneous epiphyseodeses on 25 patients. On 11 patients the epiphysiodesis was caused by an average leg length discrepancy of 2,7 cm (1-4 cm). 13 patients had angular deformity near the knee joint in frontal plane (6 valgus and 7 varus deformities). One patient suffered from a combined deformity with 3, 5 cm shortened leg and varus deviation of 10 degrees. The average deformity angle of the knee was 7,4 degrees (4 degrees -16 degrees ). 9 patients have reached maturity. On 3 patients the deformity could be corrected incompletely with residual deformity of 3 degrees, 4 degrees and 6 degrees as a direct result of late referral. On 1 patient an imminent over-correction could be avoided by hemiepiphysiodesis of the residual epiphysis. Till the present follow up the other patients have been corrected as calculated preoperatively. No complications like epiphysiolysis, infection, stiff knee or angular deformities occurred. We prefer the percutaneous epiphysiodesis as a save and minimal invasive technique instead of the open Phemister-technique to tread leg length discrepancy and angular deformities of the knee in frontal plane.
经皮骨骺阻滞术被推荐为一种安全可靠的技术。我们对25例患者进行了21例股骨远端、17例胫骨近端和3例腓骨近端的经皮骨骺阻滞术。11例患者因平均腿长差异2.7厘米(1 - 4厘米)而行骨骺阻滞术。13例患者在膝关节额状面附近存在角畸形(6例外翻和7例内翻畸形)。1例患者存在合并畸形,腿短缩3.5厘米且内翻偏差10度。膝关节的平均畸形角度为7.4度(4度 - 16度)。9例患者已达到成熟阶段。3例患者因转诊延迟,畸形未能完全矫正,残留畸形分别为度、4度和6度。1例患者通过对残留骨骺进行半骨骺阻滞术避免了即将出现的过度矫正。截至目前的随访,其他患者均如术前计算的那样得到了矫正。未发生骨骺溶解、感染、膝关节僵硬或角畸形等并发症。相较于开放的菲米斯特技术,我们更倾向于将经皮骨骺阻滞术作为一种安全且微创的技术,用于治疗腿长差异和膝关节额状面的角畸形。