Märtson Aare, Haviko Tiit, Kirjanen Kaur
Clinic of Traumatology and Orthopedics, Tartu University Clinics, Tartu, Estonia.
Medicina (Kaunas). 2005;41(10):861-6.
A case of extensive lower limb lengthening (32 cm) in a 14-year-old male patient with Ollier's disease is reported. A varus deformity of the femur and a valgus deformity of the tibia were evident. The femur was successfully lengthened 22 cm by metaphyseal distraction, and the tibia was lengthened 10 cm by two-stage distraction-compression method with a cylindrical bone allograft. Ilizarov's distraction device was used. Radiologically, a good bone regenerate was formed. Host bone has incorporated (like sarcophagi) the allograft of tibia. No evidence of vascular or neural disturbances was found. The lengthening indices were counted for femur 22.5 days per centimeter and for tibia 21 days per centimeter, altogether 15.5 days per centimeter. Bone lengthening was performed through the Ollier's disease foci. Fine needle biopsy investigation showed that most embryonic cartilage cells had been replaced with bone tissue. After five years and a 25-year follow-up the patient was satisfied with the result. The function of the knee joint was limited, but the limb was fully weight-bearing. Signs of knee osteoarthritis were found.
报告了一例14岁患骨软骨瘤病男性患者的下肢广泛延长(32厘米)病例。股骨内翻畸形和胫骨外翻畸形明显。通过干骺端牵张成功将股骨延长22厘米,采用带圆柱形同种异体骨的两阶段牵张-加压法将胫骨延长10厘米。使用了伊里扎洛夫牵张装置。放射学检查显示形成了良好的骨再生。宿主骨已融合(类似石棺)胫骨同种异体骨。未发现血管或神经功能障碍迹象。计算的延长指数为股骨每厘米22.5天,胫骨每厘米21天,总计每厘米15.5天。骨延长通过骨软骨瘤病病灶进行。细针活检研究表明,大多数胚胎软骨细胞已被骨组织取代。经过5年和25年的随访,患者对结果满意。膝关节功能受限,但肢体可完全负重。发现了膝关节骨关节炎的体征。