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应用泰勒空间框架对儿童进行肢体延长并矫正畸形

Limb lengthening combined with deformity correction in children with the Taylor Spatial Frame.

作者信息

Iobst Christopher

机构信息

Department of Orthopedic Surgery, Miami Children's Hospital, Miami, Florida 33155, USA.

出版信息

J Pediatr Orthop B. 2010 Nov;19(6):529-34. doi: 10.1097/BPB.0b013e32833dec43.

Abstract

It is difficult to replicate the regular rate and rhythm described by Ilizarov while lengthening with the Taylor Spatial Frame. The purpose of the study was to examine whether this breach of Ilizarov's principles has any deleterious effect on the ability of children to make healthy regenerate bone. A retrospective case-control study was performed comparing pediatric patients undergoing primarily lengthening with Taylor Spatial Frame rings and struts, and patients undergoing lengthening with Taylor Spatial Frame rings and Ilizarov clickers. Fifteen patients had primarily lengthening with Taylor Spatial Frame rings and struts, and six patients had lengthening with Taylor Spatial Frame rings and Ilizarov clickers. Statistically, there was no significant difference between the two groups in terms of age, latency, pre-operative bone length percentage, and average length gained. The lengthening index for the strut group (1.79 months/cm) was significantly different from the clicker group (1.33 months/cm) with P=0.012. For a pediatric patient with lower extremity long bone deformities in multiple planes, the Taylor Spatial Frame is an excellent option. However, the surgeon should anticipate a slightly longer duration of treatment with the Taylor Spatial Frame compared to Ilizarov frames and plan his/her fixation accordingly. For the straightforward lengthening of pediatric long bones without significant concomitant deformity, our results indicate that the Ilizarov method appears to be superior to the Taylor Spatial Frame struts and should still be considered the gold standard.

摘要

在使用泰勒空间框架进行肢体延长时,很难复制伊利扎洛夫所描述的规律速率和节奏。本研究的目的是检验这种对伊利扎洛夫原则的违背是否会对儿童生成健康再生骨的能力产生任何有害影响。进行了一项回顾性病例对照研究,比较主要使用泰勒空间框架环和支柱进行肢体延长的儿科患者,以及使用泰勒空间框架环和伊利扎洛夫弹片进行肢体延长的患者。15例患者主要使用泰勒空间框架环和支柱进行肢体延长,6例患者使用泰勒空间框架环和伊利扎洛夫弹片进行肢体延长。在统计学上,两组在年龄、延迟时间、术前骨长度百分比和平均延长长度方面没有显著差异。支柱组的延长指数(1.79个月/厘米)与弹片组(1.33个月/厘米)有显著差异,P = 0.012。对于患有多平面下肢长骨畸形的儿科患者,泰勒空间框架是一个很好的选择。然而,与伊利扎洛夫框架相比,外科医生应预期使用泰勒空间框架的治疗时间会稍长一些,并据此规划固定方式。对于没有明显伴随畸形的儿科长骨单纯延长,我们的结果表明,伊利扎洛夫方法似乎优于泰勒空间框架支柱,仍应被视为金标准。

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