Korzinek K, Tepic S, Perren S M
Department of Orthopaedic Surgery, Medical School, University of Zagreb, Yugoslavia.
Arch Orthop Trauma Surg. 1990;109(6):334-40. doi: 10.1007/BF00636172.
Different methods of limb lengthening as used at the Orthopedic Surgery Clinic of the Medical School, University of Zagreb, are compared. The results of operations performed between 1979 and 1989 on 111 patients are presented. These patients were subjected to surgery aimed at length equalization of limbs and/or correction of three-dimensional deformities. Lengthening was performed in 104 patients at one level, and in 7 patients at two levels of the same limb for a total of 118 procedures. In order to compare limb lengthening techniques the patients were divided into four groups: group I, original Wagner technique (45 patients); group II, Wagner technique using corticotomy (33 patients); group III, original Ilizarov technique (35 patients); group IV, continuous lengthening (2 patients). The evaluation covered radiological aspects of regenerated bone, complications and basic lengthening parameters. The results indicate that corticotomy has considerable advantages over osteotomy, provided bone circulation is maintained. These advantages manifest themselves in a reduced number of operations, lower incidence of infection and improved bone regeneration. It is preferable to perform corticotomy at the metaphysis site because of its optimum blood supply and its higher potential for osteogenesis. With corticotomy performed at the diaphysis site, satisfactory results were observed in only one-third of the cases.
对萨格勒布大学医学院整形外科诊所采用的不同肢体延长方法进行了比较。介绍了1979年至1989年期间对111例患者实施手术的结果。这些患者接受了旨在使肢体长度均等和/或矫正三维畸形的手术。104例患者在一个部位进行了延长，7例患者在同一肢体的两个部位进行了延长，总共进行了118次手术。为了比较肢体延长技术，将患者分为四组：第一组，原始瓦格纳技术（45例患者）；第二组，采用皮质切开术的瓦格纳技术（33例患者）；第三组，原始伊里扎洛夫技术（35例患者）；第四组，持续延长（2例患者）。评估涵盖了再生骨的放射学方面、并发症和基本延长参数。结果表明，只要保持骨循环，皮质切开术相对于截骨术具有相当大的优势。这些优势表现为手术次数减少、感染发生率降低和骨再生改善。由于干骺端部位血供最佳且成骨潜力更高，因此在该部位进行皮质切开术更为可取。在骨干部位进行皮质切开术时，仅三分之一的病例观察到了满意的结果。
