Davids J R, Fisher R, Lum G, Von Glinski S
Department of Orthopaedics, University of Colorado Health Science Center, Denver.
J Pediatr Orthop. 1992 May-Jun;12(3):291-9. doi: 10.1097/01241398-199205000-00004.
We have treated 15 children with end-stage renal disease (ESRD), renal osteodystrophy, and genu valgum in the last 22 years. In a retrospective review, we determined that periods of metabolic instability, best characterized as an alkaline phosphatase of 500 U for at least 10 months, were associated with progression of deformity. Histomorphometric bone biopsy provided information that proved essential for effective evaluation and treatment in this group. Complications of corrective osteotomy were related to perioperative metabolic instability. A surgical treatment protocol is described, emphasizing preoperative assessment by histomorphometric bone biopsy and multimodal medical management to maintain metabolic stability perioperatively.
在过去22年里，我们共治疗了15名终末期肾病（ESRD）、肾性骨营养不良和膝外翻患儿。通过回顾性研究，我们确定，以碱性磷酸酶至少500 U持续至少10个月为特征的代谢不稳定期与畸形进展相关。组织形态计量学骨活检提供的信息被证明对该组患者的有效评估和治疗至关重要。截骨矫形术的并发症与围手术期代谢不稳定有关。本文描述了一种手术治疗方案，强调通过组织形态计量学骨活检进行术前评估以及采用多模式医疗管理以维持围手术期的代谢稳定性。
