Janoyer Marc, Jabbari Houcine, Rouvillain Jean Louis, Sommier Jacques, Py Gérard, Catonné Yves, Colombani Jean François
Department of Pediatric Surgery, University of Fort de France, Martinique, France.
J Pediatr Orthop B. 2007 Jul;16(4):273-80. doi: 10.1097/01.bpb.0000210591.35652.84.
The treatment of infantile Blount's disease remains controversial. The progressive development of epiphysiodesis of the medial tibial physis induced a complex deformity of the lower limb such as severe genu varum, joint incongruity, torsion instability and leg length discrepancy with major functional consequences. Nine knees on eight children (average age was 7 years and 2 months) were treated by a one-time procedure using a specific external fixator that combined elevation of the medial tibial plateau, axial correction in the valgus, complete sterilization of the upper tibial growth cartilage, leg lengthening anticipation and de-rotation if necessary. Magnetic resonance imaging was useful to describe the deformity and to prepare for surgery. Corrections were progressively obtained through the physis plan by means of short incisions and the use of a specific external fixator. The primary results at an average of 24 months were good with a low rate of complications but final evaluation will be conducted at the end of the children's growth period.
小儿布朗特病的治疗仍存在争议。胫骨内侧骨骺过早闭合的渐进性发展会导致下肢出现复杂畸形，如严重膝内翻、关节不协调、扭转不稳定以及腿长差异，从而产生严重的功能后果。对8名儿童（平均年龄为7岁2个月）的9个膝关节采用一次性手术治疗，使用一种特殊的外固定器，该外固定器结合了胫骨内侧平台抬高、外翻轴向矫正、胫骨近端生长软骨完全灭活、预期性腿延长以及必要时的去旋转操作。磁共振成像有助于描述畸形情况并为手术做准备。通过短切口并使用特殊外固定器，逐步通过骨骺平面进行矫正。平均24个月时的初步结果良好，并发症发生率较低，但最终评估将在儿童生长期结束时进行。
