El-Mowafi Hani, Abulsaad Mazen, El-Adl Wael
Mansoura University, Mansoura, Egypt.
Acta Orthop Belg. 2005 Oct;71(5):577-81.
The treatment of anterolateral bowing with an intact tibia is directed toward prevention of the fracture and subsequent pseudoarthrosis. Patients with anterolateral bowing of the tibia are usually treated with an ankle-foot orthosis until the deformity is improved. There is no documentation that an orthosis can prevent the fracture or correct the deformity, and if the deformity is not corrected, it will result in different mechanical problems. In this study, 6 legs in 6 patients with anterolateral bowing of the tibia with a narrow sclerotic medullary canal (Crawford type II) were treated using Ilizarov's method. The average age was 6.8 years. All patients underwent correction of the anterolateral bowing by excision of the affected part. If the gap was less than 4 cm, acute shortening followed by bone lengthening was done. If the gap was more than 4 cm, bone transport was preferred. The mean duration of follow-up was 3.2 years. The anterolateral bowing was corrected in all patients. Complications such as pin track infection, premature consolidation and delayed union at the docking site were encountered. We believe that Ilizarov's method offers a more efficient solution for this type of deformity than prophylactic orthotic treatment or prophylactic bypass bone graft.
对于胫骨完整的前外侧弓形腿的治疗旨在预防骨折及随后的假关节形成。胫骨前外侧弓形腿患者通常用踝足矫形器进行治疗，直至畸形改善。没有文献证明矫形器能预防骨折或纠正畸形，而且如果畸形未得到纠正，将会导致不同的力学问题。在本研究中，对6例患有胫骨前外侧弓形腿且髓腔狭窄硬化（克劳福德II型）的患者的6条腿采用伊里扎洛夫方法进行治疗。平均年龄为6.8岁。所有患者均通过切除患部来矫正前外侧弓形腿。如果间隙小于4 cm，则先进行急性缩短然后骨延长。如果间隙大于4 cm，则优先采用骨搬运。平均随访时间为3.2年。所有患者的前外侧弓形腿均得到矫正。出现了诸如针道感染、对接部位过早骨愈合和延迟骨愈合等并发症。我们认为，与预防性矫形治疗或预防性旁路植骨相比，伊里扎洛夫方法为这类畸形提供了一种更有效的解决方案。
