Kenwright J, Albinana J
Nuffield Orthopaedic Centre, Headington, Oxford, England.
J Bone Joint Surg Br. 1991 Jul;73(4):671-5. doi: 10.1302/0301-620X.73B4.2071658.
We reviewed 46 leg-shortening operations (37 femoral and nine tibial), performed by different methods, to assess the incidence of complications and permanent disability. Shortening of as much as 7.5 cm in the femur and 5 cm in the tibia was achieved in men of normal height without any loss of function. Complications were seen with all surgical techniques despite the use of modern implants. Most problems arose from inadequate stabilisation of the osteotomy. The most reliable method of femoral shortening was open subtrochanteric osteotomy with preservation of the isthmus, and fixation with an intramedullary nail locked at its proximal end. In tibial shortening, bone excision should be at the level of the flare in the lower diaphysis in order to achieve reliable bone healing. Simple intramedullary nail fixation should be supplemented with a long-leg cast for six weeks or the nail should be locked at both ends to prevent postoperative distraction or rotation.
我们回顾了采用不同方法进行的46例肢体缩短手术（37例股骨手术和9例胫骨手术），以评估并发症和永久性残疾的发生率。身高正常的男性股骨缩短可达7.5厘米，胫骨缩短可达5厘米，且功能无任何丧失。尽管使用了现代植入物，但所有手术技术均出现了并发症。大多数问题源于截骨术固定不充分。股骨缩短最可靠的方法是保留峡部的开放转子下截骨术，并用近端锁定的髓内钉固定。在胫骨缩短手术中，骨切除应在干骺端下段的膨大处，以实现可靠的骨愈合。单纯的髓内钉固定应辅以长腿石膏固定六周，或者髓内钉两端都应锁定，以防止术后出现骨块分离或旋转。
