Schep Niels Willem Luitzen, van Lieshout Esther M M, Patka Peter, Vogels Lucas M M
Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Strategies Trauma Limb Reconstr. 2009 Dec;4(3):107-12. doi: 10.1007/s11751-009-0070-3. Epub 2009 Nov 24.
Limb length discrepancy and segmental bone defects can be difficult problems to manage after fractures of the lower limb. Distraction osteogenesis can be applied to lengthen bone or to bridge intercalary defects by segmental bone transport. The purpose of this study was to assess the functional outcome and long-term quality of life after distraction osteogenesis of the lower limb when applied for post-traumatic problems. Three patients were treated with segmental transport for bone loss secondary to infection and debridement after a tibia fracture. Leg lengthening was performed in 12 patients with consolidated fractures (eight femurs and four tibias). Long-term functional outcomes were evaluated with the Short Form-36 Health Survey (SF-36) and the Lower Extremity Functional Scale (LEFS) in all patients. The mean follow-up was 9 years. Functional outcomes indicated moderate difficulty in patients after segmental transport and a little difficulty in patients after lengthening of consolidated fractures. The SF-36 scores varied two points for physical functioning and one point for bodily pain as compared to the SF-36 norm-based scores. In all other six domains, patient scores were comparable with the general population. In conclusion, the quality of life and functional outcome returned to normal after post-traumatic distraction osteogenesis of the lower limb.
下肢骨折后，肢体长度差异和节段性骨缺损可能是难以处理的问题。牵张成骨可用于延长骨骼或通过节段性骨运输来桥接节段间缺损。本研究的目的是评估下肢牵张成骨用于创伤后问题时的功能结局和长期生活质量。3例患者因胫骨骨折后感染和清创导致骨缺损而接受节段性骨运输治疗。12例骨折已愈合的患者（8例股骨和4例胫骨）进行了肢体延长。所有患者均采用简短健康调查问卷（SF-36）和下肢功能量表（LEFS）评估长期功能结局。平均随访时间为9年。功能结局显示，节段性骨运输后的患者有中度困难，骨折已愈合的患者延长后有轻度困难。与基于SF-36常模的分数相比，身体功能的SF-36分数相差2分，身体疼痛相差1分。在所有其他六个领域，患者分数与一般人群相当。总之，下肢创伤后牵张成骨后生活质量和功能结局恢复正常。
