Horn Joachim, Kristiansen Leif Pål, Steen Harald
Department of Orthopaedics, University Hospital Rikshospitalet, Oslo, Norway.
Acta Orthop Belg. 2009 Apr;75(2):219-24.
The purpose of this study was to evaluate our treatment protocol for certain physeal injuries requiring complete epiphysiodesis of an injured physis, angular correction and lengthening with the Ilizarov method and overcorrection of length according to calculated loss of remaining growth. Five patients (age: 12 to 14 years) were operated with angular correction and lengthening in combination with complete epiphysiodesis. Angular deformities measured 12 degrees to 24 degrees and limb length discrepancies (LLD's) 15 to 60 mm. Mean overcorrection of length according to remaining growth of the affected physis was 12 mm (range: 7 to 15). All deformity parameters were fully corrected in all patients. Mechanical axis deviation (MAD) was within +/- 5 mm compared to the healthy side in 4 patients, 20 mm in one patient. Median LLD at maturity was 8 mm (range: 3 to 13). In cases of partial physeal arrest with severe symptomatic deformities, complete epiphysiodesis of the injured physis, angular correction and lengthening with the Ilizarov method with overcorrection of length according to estimated loss of remaining growth of the affected physis is a suitable method.
本研究的目的是评估我们针对某些需要对受伤骨骺进行完全骺板固定、采用伊里扎洛夫方法进行角度矫正和肢体延长以及根据剩余生长的计算损失进行长度过度矫正的骨骺损伤的治疗方案。5例患者(年龄12至14岁)接受了角度矫正和延长联合完全骺板固定手术。角度畸形为12度至24度,肢体长度差异(LLD)为15至60毫米。根据受影响骨骺的剩余生长情况,长度平均过度矫正为12毫米(范围:7至15毫米)。所有患者的所有畸形参数均得到完全矫正。4例患者的机械轴偏差(MAD)与健侧相比在±5毫米以内,1例患者为20毫米。成熟时的LLD中位数为8毫米(范围:3至13毫米)。对于伴有严重症状性畸形的部分骨骺阻滞病例,对受伤骨骺进行完全骺板固定、采用伊里扎洛夫方法进行角度矫正和延长并根据受影响骨骺剩余生长的估计损失进行长度过度矫正是一种合适的方法。