Johari Ashok N, Dhawale Arjun A, Salaskar Abhijit, Aroojis Alaric J
Children's Orthopaedic Centre, Mumbai, Maharashtra, India.
J Pediatr Orthop B. 2010 Nov;19(6):479-86. doi: 10.1097/BPB.0b013e32833ccac2.
We report the results of surgical treatment of congenital postero-medial bowing of the tibia and fibula. Twenty patients with congenital postero-medial bowing were seen with nine patients treated surgically (corrective osteotomy or lengthening and deformity correction with Ilizarov fixator) and 11 patients managed conservatively. The angles of medial and posterior angulation and limb length discrepancy were recorded serially and compared. Surgical complications were recorded. The mean follow-up was 9.5 and 6.1 years after surgery. Although there was a reduction in angulation and correction of limb length discrepancy, we encountered complications in the surgically treated patients. There was no statistically significant difference between the surgically treated and conservatively managed groups with respect to mean angulation, though there was a significant difference in the mean limb length discrepancy. In conclusion, we advocate a one-stage lengthening and correction of the residual deformity closer to skeletal maturity.
我们报告了先天性胫腓骨后内侧弓形弯曲的手术治疗结果。共诊治了20例先天性胫腓骨后内侧弓形弯曲患者，其中9例接受了手术治疗（截骨矫形或使用伊里扎洛夫固定器延长并矫正畸形），11例采用保守治疗。连续记录并比较了内翻和后凸角度以及肢体长度差异。记录手术并发症。术后平均随访时间分别为9.5年和6.1年。尽管角度有所减小且肢体长度差异得到了矫正，但我们在接受手术治疗的患者中遇到了并发症。在平均角度方面，手术治疗组和保守治疗组之间没有统计学上的显著差异，不过在平均肢体长度差异方面存在显著差异。总之，我们主张在骨骼成熟度更高时进行一期延长并矫正残余畸形。
