Matsubara Hidenori, Tsuchiya Hiroyuki, Sakurakichi Keisuke, Watanabe Koji, Tomita Katsuro
Department of Orthopedic Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
Int Orthop. 2006 Dec;30(6):550-4. doi: 10.1007/s00264-006-0133-8. Epub 2006 May 12.
Deformities combined with shortening in 34 lower limb segments of 28 patients were treated with an Ilizarov external fixator or a Taylor spatial frame at the same level as the osteotomy. We compared an acute correction group (A) with a gradual correction group (G) in patients undergoing deformity correction followed by lengthening. We retrospectively examined the amount of deformity correction, length gained, distraction index, maturation index, and external fixation index in both groups. The mean age of subjects was 12.9 years for A, 17.9 years for G. The mean deformity correction was 17.8 degrees for A, 25.1 degrees for G. Mean lengthening was 5.5 cm for A, 5.0 cm for G. Mean distraction index was 16.4 days/cm for A, 10.6 days/cm for G (P<0.05). Mean maturation index was 40.5 days/cm for A, 29.5 days/cm for G (P=0.081). Mean external fixation index was 58.6 days/cm for A, 42.5 days/cm for G (P<0.05). The distraction index and external fixation index differences between the two groups were statistically significant. Gradual correction may represent a better approach than acute correction with the use of external fixators to treat deformity combined with shortening.
对28例患者34个下肢节段的畸形合并短缩情况,在截骨水平使用伊里扎洛夫外固定架或泰勒空间架进行治疗。我们将畸形矫正后行延长术的患者分为急性矫正组(A组)和逐步矫正组(G组)进行比较。我们回顾性研究了两组的畸形矫正量、延长长度、牵张指数、成熟指数和外固定指数。A组受试者的平均年龄为12.9岁,G组为17.9岁。A组的平均畸形矫正角度为17.8度,G组为25.1度。A组的平均延长长度为5.5厘米,G组为5.0厘米。A组的平均牵张指数为16.4天/厘米,G组为10.6天/厘米(P<0.05)。A组的平均成熟指数为40.5天/厘米,G组为29.5天/厘米(P=0.081)。A组的平均外固定指数为58.6天/厘米,G组为42.5天/厘米(P<0.05)。两组之间的牵张指数和外固定指数差异具有统计学意义。在使用外固定架治疗畸形合并短缩时,逐步矫正可能比急性矫正更具优势。