Schiedel F M, Pip S, Wacker S, Pöpping J, Tretow H, Leidinger B, Rödl R
Department of Children's Orthopaedics, Deformity Correction and Foot Surgery, Münster University Hospital, Albert-Schweitzer-Strasse 33, D-48149 Münster, Germany.
J Bone Joint Surg Br. 2011 Jun;93(6):788-92. doi: 10.1302/0301-620X.93B6.25581.
We report the results of intramedullary leg lengthening conducted between 2002 and 2009 using the Intramedullary Skeletal Kinetic Distractor in 69 unilateral lengthenings involving 58 femora and 11 tibiae. We identified difficulties that occurred during the treatment and assessed whether they were specifically due to the implant or independent of it. Paley's classification for evaluating problems, obstacles and complications with external fixators was adopted, and implant-specific difficulties were continuously noted. There were seven failures requiring premature removal of the device, in four due to nail breakage and three for other reasons, and five unsuccessful outcomes after completion of the lengthening. In all, 116 difficulties were noted in 45 patients, with only 24 having problem-free courses. In addition to the difficulties arising from the use of external fixators, there were almost the same number again of implant-specific difficulties. Nevertheless, successful femoral lengthening was achieved in 52 of the 58 patients (90%). However, successful tibial lengthening was only achieved in five of 11 patients (45%).
我们报告了2002年至2009年间使用髓内骨骼动力撑开器进行的69例单侧肢体延长手术的结果，其中包括58例股骨延长和11例胫骨延长。我们确定了治疗过程中出现的困难，并评估了这些困难是否具体归因于植入物或与之无关。采用了佩利（Paley）评估外固定器问题、障碍和并发症的分类方法，并持续记录与植入物相关的困难。有7例失败病例需要提前取出装置，其中4例是由于髓内钉断裂，3例是其他原因，还有5例在延长完成后效果不佳。总共在45例患者中记录到116个困难，只有24例患者治疗过程顺利。除了使用外固定器产生的困难外，与植入物相关的困难数量几乎与之相同。然而，58例患者中有52例（90%）成功实现了股骨延长。但是，11例患者中只有5例（45%）成功实现了胫骨延长。
