Ramseier Leonhard E, Sukthankar Atul, Exner G Ulrich
Department of Orthopaedics, University of Zurich, Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland,
J Child Orthop. 2009 Feb;3(1):33-7. doi: 10.1007/s11832-008-0155-4. Epub 2009 Jan 6.
Leg length discrepancy and angular deformities can, in contrast to adults; easily be corrected with epiphysiodesis during growth. Goal of this study was to evaluate our results of a modified Canale technique for definitive epiphysiodesis treating leg length discrepancy and also angular deformities.
Between 2000 and 2007, 22 patients (11 boys and 11 girls) were subjected to definitive epiphysiodesis. In total 73 hemiepiphysiodesis were performed (26 proximal tibial, 47 distal femoral).
All patients could be followed to the end of growth. Mean follow-up was 32.2 month (range 13-76 months). In 20 patients the epiphysiodesis was planed to correct axis and leg length discrepancy. In two patients' contralateral epiphysiodesis was performed to avoid further leg length discrepancy because of closed physis of the shorter affected side. A staged procedure was necessary in nine patients to achieve the best possible correction. No complications were seen such as wound healing, knee-joint contractures after epiphysiodesis of the distal femur and proximal tibia. In two patients three rehemiepiphysiodesis because of not fully closure of the physis had to be done.
Definitive epiphysiodesis using this modified Canale technique is a safe, minimal invasive method to correct leg length discrepancy and angular deformities if preoperative planning is performed properly.
与成人不同,生长期间的腿长差异和角畸形可通过骨骺阻滞术轻松矫正。本研究的目的是评估我们采用改良Canale技术进行确定性骨骺阻滞术治疗腿长差异和角畸形的结果。
2000年至2007年期间,22例患者(11名男孩和11名女孩)接受了确定性骨骺阻滞术。共进行了73次半骨骺阻滞术(26次胫骨近端,47次股骨远端)。
所有患者均随访至生长结束。平均随访时间为32.2个月(范围13 - 76个月)。20例患者进行骨骺阻滞术以矫正轴线和腿长差异。2例患者因患侧较短侧骨骺闭合而进行对侧骨骺阻滞术以避免进一步的腿长差异。9例患者需要分阶段进行手术以实现最佳矫正。未观察到并发症,如伤口愈合、股骨远端和胫骨近端骨骺阻滞后的膝关节挛缩。2例患者因骨骺未完全闭合不得不进行3次再次半骨骺阻滞术。
如果术前规划得当,采用这种改良Canale技术进行确定性骨骺阻滞术是一种安全、微创的方法,可用于矫正腿长差异和角畸形。