Kokavec M, Gajdos M, Fristáková M, Huraj E
Detská ortopedická klinika LFUK a DFNsP, Bratislava, Slovenská republika.
Acta Chir Orthop Traumatol Cech. 2008 Aug;75(4):297-300.
The authors analyse the first results of correction surgery for limb-length inequality and rotational and angular deformities of the tibia using the Taylor spatial frame in combination with the Ilizarov external fixator in three patients. The shortening of the tibia, 65 mm on the average (55, 60 and 80 mm, respectively), was due to tibial hemimilia in two patients and traumatic epiphyseolysis of the distal tibia in one patient. Distraction at a rate of 1 mm/day was controlled three-times a day on two contralateral struts. It started on the seventh day after osteotomy in all three patients. On the second post-operative day, rehabilitation started with standing up and walking with crutches. The additional fixation of the heel and foot was removed at 3 months after distraction was terminated so that ankle exercise would be possible. No serious complications were recorded. The average distraction index was 0.91 and the average tibial lengthening was 65 mm. Callus consolidation was achieved at 131 days after the end of distraction phase. Approximately at 10 months post-operatively, the patients reported full weight-bearing of the extremity.
作者分析了3例患者使用泰勒空间架结合伊里扎洛夫外固定器治疗肢体长度不等以及胫骨旋转和角度畸形的初次手术结果。胫骨缩短平均65毫米(分别为55毫米、60毫米和80毫米),2例患者是由于胫骨半肢畸形,1例患者是由于胫骨远端创伤性骨骺溶解。每天以1毫米的速度进行牵引,在两根对侧支柱上每天控制3次。所有3例患者均在截骨术后第7天开始牵引。术后第2天,康复从使用拐杖站立和行走开始。在牵引结束3个月后去除足跟和足部的额外固定装置,以便进行踝关节锻炼。未记录到严重并发症。平均牵引指数为0.91,胫骨平均延长65毫米。在牵引阶段结束后131天实现骨痂巩固。术后约10个月,患者报告患侧肢体可完全负重。