Qin Si-he, Sun Lei, Zheng Xue-jian
Department of Orthopaedics, Beijing Chaoyang District Orthopaedics Hospital, Beijing 100024, China.
Zhonghua Wai Ke Za Zhi. 2006 Apr 15;44(8):547-50.
To explore the Ilizarov mini-invasive distraction technique for the treatment of severer ankle and foot deformities secondary to ischemic contracture of the leg.
Based on the tension-stress low of Ilizarov, a serial of adjustable three dimensions external distractive instrument was developed in our department. From April 2002 to March 2004, 8 patients with ankle and foot deformities secondary to ischemic contracture of the leg induced by trauma and fracture were treated with the distractive instrument. Of them, 4 patient were male and 4 female, aged from 13 to 31 years with an average of 23 years. Five affected legs were in the left and 3 in the right. Preoperative abnormal style included talipes equines in 6 feet and equinovarus in 2 feet, with extensive scar contracture in the legs. Five patients suffered from failure of soft tissue release before, two patients with severe bony deformity of the feet were underwent limited foot triple osteotomy in this department before the distractive correction. The distraction was begun from 7 d after operation and distractive time from 29 to 60 d with an average 46 d.
All of the 8 patients were followed up from 10 months to 29 months, with an average of 13 months. All of deformities in the feet were corrected satisfactorily, full feet contacted with the ground in stand or walking and achieved with good function. No complication, such as pin tract infection, skin necrosis and neurovascular injury was occurred in this group.
Mini-invasive distraction technique for treatment of severe ankle and foot deformity secondary to ischemic contracture of the leg is safe and mini-injury, it is also an effective approach for the treatment of various kinds of rigid foot anomaly.
探讨伊里扎洛夫微创牵张技术治疗小腿缺血性肌挛缩继发的重度踝足畸形。
根据伊里扎洛夫的张力 - 应力法则,我科研制了一系列可调节的三维体外牵张器械。2002年4月至2004年3月,应用该牵张器械治疗8例因创伤和骨折导致小腿缺血性肌挛缩继发踝足畸形的患者。其中男性4例,女性4例,年龄13~31岁,平均23岁。左侧患肢5例,右侧3例。术前畸形类型包括马蹄足6足,马蹄内翻足2足,小腿均有广泛瘢痕挛缩。5例患者既往软组织松解失败,2例足部严重骨畸形患者在牵张矫正前在本科行有限的足部三关节截骨术。术后7天开始牵张,牵张时间29~60天,平均46天。
8例患者均获随访,随访时间10个月至29个月,平均13个月。足部畸形均得到满意矫正,站立或行走时全足着地,功能良好。本组无针道感染、皮肤坏死及神经血管损伤等并发症发生。
微创牵张技术治疗小腿缺血性肌挛缩继发的重度踝足畸形安全、微创,是治疗各种僵硬性足部畸形的有效方法。