Inan Muharrem, Chan Gilbert, Littleton Aaron G, Kubiak Paul, Bowen J Richard
Department of Orthopedics, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, Wilmington, DE 19899, USA.
J Pediatr Orthop. 2008 Sep;28(6):648-51. doi: 10.1097/BPO.0b013e3181832475.
The aims of this study were to evaluate outcomes of percutaneous epiphysiodesis, as described by Bowen, in 97 patients and to assess complications and determine whether the effect of the epiphysiodesis will accurately follow the Moseley chart predictions.
A total of 97 patients were reviewed retrospectively. Fifty-six girls and 41 boys, with a mean skeletal age of 12.6 years (range, 10-16 years) at the time of operation, were followed up until skeletal maturity, a mean of 3.8 years (range, 1-10 years).
The mean residual leg length discrepancy (LLD) in 88 patients at maturity was 1.3 cm (range, 0-3.5 cm). In 9 patients, the epiphysiodesis was combined with a femoral lengthening or femoral shortening. The residual leg length discrepancy in these 9 patients was 3.3 cm at maturity (range, 0-6.5 cm). Minor complications including knee effusion (n = 2), superficial wound infection (n = 1), and exostosis (n = 3) occurred in 6 patients. Failure of the epiphysiodesis was the only major complication seen (n = 3).
This study shows that complications are infrequent when performing percutaneous epiphysiodesis and that the Moseley straight-line method accurately and efficaciously predicted the timing for percutaneous epiphysiodesis in all but one patient who had unpredictable growth from hemihypertrophy secondary to a hemangiomatosis.
本研究的目的是评估鲍恩所描述的经皮骨骺阻滞术在97例患者中的治疗效果，评估并发症，并确定骨骺阻滞术的效果是否能准确遵循莫斯利图表的预测。
对97例患者进行回顾性分析。56名女孩和41名男孩，手术时平均骨龄为12.6岁（范围10 - 16岁），随访至骨骼成熟，平均随访3.8年（范围1 - 10年）。
88例患者成熟时的平均下肢长度残余差异（LLD）为1.3厘米（范围0 - 3.5厘米）。9例患者的骨骺阻滞术与股骨延长或股骨缩短联合进行。这9例患者成熟时的下肢长度残余差异为3.3厘米（范围0 - 6.5厘米）。6例患者出现轻微并发症，包括膝关节积液（n = 2）、浅表伤口感染（n = 1）和骨疣（n = 3）。骨骺阻滞术失败是唯一观察到的主要并发症（n = 3）。
本研究表明，进行经皮骨骺阻滞术时并发症很少见，并且除了1例因血管瘤病继发半侧肥大导致生长不可预测的患者外，莫斯利直线法准确有效地预测了经皮骨骺阻滞术的时机。
