Peterson Brett M, McCarroll H Relton, James Michelle A
Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA, USA.
J Hand Surg Am. 2007 Nov;32(9):1402-7. doi: 10.1016/j.jhsa.2007.07.024.
Children with radial longitudinal deficiency have very short forearms. The Ilizarov method of distraction osteogenesis has been used to increase extremity length, but results differ with the underlying condition and the limb being lengthened. The purpose of this study is to examine retrospectively the outcomes of Ilizarov lengthening of the ulna in children with radial longitudinal deficiency.
Nine children with radial longitudinal deficiency had 13 ulnar lengthenings using the Ilizarov method; 8 with unilateral deficiency had 9 lengthenings to improve appearance, and 1 child with bilateral radial longitudinal deficiency had 4 lengthenings to improve function. All had previous wrist centralization surgery, and all but 1 had a carpal osteotomy at the time of lengthening to reduce residual wrist angulation.
The average gain for each lengthening was 4.4 cm (range 1.8-8.0 cm) with an average lengthening index of 9 weeks per cm (range 4-24 weeks per cm). All patients at each lengthening experienced at least 1 pin site infection that required antibiotic treatment. Other complications included delayed union requiring internal fixation and bone grafting in 3 lengthenings and recurrence of radial deviation requiring shortening and wrist arthrodesis in 1 case.
The Ilizarov technique is an effective method for lengthening the ulna in children with radial longitudinal deficiency. The process of lengthening is prolonged and arduous with frequent complications. In successful cases, however, patients are pleased with the function and appearance of their lengthened forearms.
桡骨纵列发育不全的儿童前臂非常短。伊利扎洛夫牵张成骨方法已被用于增加肢体长度，但结果因潜在病情和延长的肢体不同而有所差异。本研究的目的是回顾性研究伊利扎洛夫技术延长桡骨纵列发育不全儿童尺骨的效果。
9例桡骨纵列发育不全的儿童采用伊利扎洛夫技术进行了13次尺骨延长；8例单侧发育不全的患儿进行了9次延长以改善外观，1例双侧桡骨纵列发育不全的患儿进行了4次延长以改善功能。所有患儿均曾接受过腕关节中心化手术，除1例患儿外，其余患儿在延长时均进行了腕骨截骨术以减少残留的腕关节成角。
每次延长的平均增加长度为4.4厘米（范围为1.8 - 8.0厘米），平均延长指数为每厘米9周（范围为每厘米4 - 24周）。每次延长时，所有患儿至少经历1次需要抗生素治疗的针道感染。其他并发症包括3次延长出现延迟愈合，需要进行内固定和植骨，1例出现桡骨偏斜复发，需要缩短和腕关节融合。
伊利扎洛夫技术是延长桡骨纵列发育不全儿童尺骨的有效方法。延长过程漫长且艰巨，并发症频繁。然而，在成功的病例中，患者对延长后的前臂功能和外观感到满意。
