Franke J, Hein G, Simon M, Hauch S
Department of Orthopaedic Surgery, Medical Academy Erfurt, Federal Republic of Germany.
Int Orthop. 1990;14(4):405-13. doi: 10.1007/BF00182654.
We have used Ilazorov's method of distraction epiphyseolysis for leg lengthening since 1977 and his new method of corticotomy or compactotomy since 1983. The first method was carried out in 22 lower limbs with an average lengthening of 8.25 cm (range 4 to 18 cm); included in this group are 2 patients with achondroplasia in whom both legs were lengthened 12 cm. In the second method, a corticotomy is carried out at the metaphyseal-diaphyseal junction followed by distraction in Ilazorov's apparatus (4 x 0.25 mm a day). We lengthened 30 legs; included are 5 patients who had both legs lengthened from between 8 and 12 cm. In the remainder an average of 7.9 cm of lengthening was achieved (range from 4 to 15 cm). The index for the treatment time per cm achieved (time from operation until full weight-bearing per cm of lengthening) was shorter after distraction epiphyseolysis than after corticotomy. Complications were also a little less after the latter procedure. Distraction epiphyseolysis has to be limited to children from aged 12 years until growth ceases. The advantage with corticotomy is that it can be done at any age from 5 to 30 years. Care is needed in both cases to avoid complications.
自1977年以来，我们一直采用伊拉佐罗夫的骨骺牵张分离术来延长腿部，自1983年起采用他的新方法——骨皮质切开术或致密骨切开术。第一种方法应用于22条下肢，平均延长8.25厘米（范围为4至18厘米）；该组包括2例软骨发育不全患者，其双腿均延长了12厘米。在第二种方法中，在干骺端-骨干交界处进行骨皮质切开术，然后在伊拉佐罗夫器械中进行牵张（每天4×0.25毫米）。我们延长了30条腿；其中包括5例双腿延长8至12厘米的患者。其余患者平均延长7.9厘米（范围为4至15厘米）。每延长1厘米所需的治疗时间指数（从手术到完全负重每延长1厘米的时间）在骨骺牵张分离术后比骨皮质切开术后短。后一种手术的并发症也略少。骨骺牵张分离术必须限于12岁至生长停止的儿童。骨皮质切开术的优点是可以在5至30岁的任何年龄进行。两种情况都需要小心以避免并发症。
