Grill F, Dungl P
Paediatric Orthopaedic Department, Speising Hospital, Vienna, Austria.
J Bone Joint Surg Br. 1991 May;73(3):439-47. doi: 10.1302/0301-620X.73B3.1670446.
We have reviewed the results in 37 patients with unilateral congenital short femur (Pappas classes III to IX), treated by different lengthening procedures. The increase in the length of the femur varied from 15.6% to 142%, excellent or good results being obtained in 32 patients (86%). There was an average of 1.9 complications per case, most being seen earlier in the series when the Wagner technique was used. With the Orthofix and the Ilizarov techniques, we used callus distraction in all cases. We found that the proximal diaphysis of the congenitally abnormal femur healed less well, and we now prefer to perform corticotomy and callus distraction of the distal metaphysis. The Ilizarov method gave the best results, offering the possibilities of the simultaneous use of a Hoffmann fixator across the hip and the treatment of knee dislocation and instability.
我们回顾了37例单侧先天性股骨短小（帕帕斯III至IX级）患者采用不同延长手术治疗的结果。股骨长度增加幅度从15.6%至142%不等，32例患者（86%）获得了优良结果。每例平均有1.9种并发症，多数并发症出现在系列研究早期使用瓦格纳技术时。采用奥托立夫和伊里扎洛夫技术时，我们在所有病例中均使用骨痂牵张术。我们发现先天性异常股骨的近端骨干愈合较差，现在我们更倾向于对远端干骺端进行皮质切开术和骨痂牵张术。伊里扎洛夫方法效果最佳，可同时使用霍夫曼固定器固定髋关节，还能治疗膝关节脱位和不稳定。
