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在青少年患者中使用Fitbone电动髓内钉系统进行下肢延长和畸形矫正。

Lower limb lengthening and deformity correction using the Fitbone motorized nail system in the adolescent patient.

作者信息

Al-Sayyad Mohammed J

机构信息

Department of Orthopedic Surgery, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

出版信息

J Pediatr Orthop B. 2012 Mar;21(2):131-6. doi: 10.1097/BPB.0b013e32834b34b4.

Abstract

Leg lengthening by an external fixation is associated with various difficulties. Pin-tract infections are commonly encountered, and muscle contractures and joint stiffness are additional complications associated with this method. Several researchers explored a purely intramedullary solution for leg lengthening since the 1970s. The purpose of this study was to evaluate the results of 10 adolescent patients who underwent leg lengthening with a motorized intramedullary lengthening device (the Fitbone System). We aimed to evaluate the effectiveness of the Fitbone system in deformity correction and lengthening of the femur and tibia in the pediatric and adolescent patients looking at whether the incidence of complications commonly associated with external fixators could be reduced. We compared our preliminary results with those from other reports, with a focus on leg length achieved and rate of complications. Ten patients were included, nine femoral nails and five tibial nails were implanted. The average lengthening distance was 4.8 cm (range, 2.8-10 cm). In 10 patients, leg lengthening was combined with successful correction of the mechanical axis alignment in three patients. The consolidation index averaged 24 days/cm (range, 20-39 days/cm). The average hospital stay was 8 days. No bone or soft tissue infections were observed. Only one patient had irritation and pain from the antenna system after lengthening and recovered fully after antenna removal. Our results suggest that the difficulties commonly associated with external fixators can be reduced with this method. It also allows good angular correction in patients with mechanical axis deviation. These features combined with a short time of hospitalization make it a promising procedure for limb lengthening in adolescent patients.

摘要

通过外固定进行肢体延长会带来各种困难。针道感染很常见,肌肉挛缩和关节僵硬是与该方法相关的其他并发症。自20世纪70年代以来,一些研究人员探索了一种单纯的髓内肢体延长解决方案。本研究的目的是评估10例接受电动髓内延长装置(Fitbone系统)进行肢体延长的青少年患者的治疗结果。我们旨在评估Fitbone系统在矫正小儿和青少年患者股骨和胫骨畸形及延长方面的有效性,观察是否能降低通常与外固定器相关的并发症发生率。我们将初步结果与其他报告的结果进行比较,重点关注肢体延长长度和并发症发生率。纳入10例患者,植入9枚股骨钉和5枚胫骨钉。平均延长距离为4.8厘米(范围为2.8 - 10厘米)。10例患者中,3例在肢体延长的同时成功矫正了机械轴对线。骨愈合指数平均为24天/厘米(范围为20 - 39天/厘米)。平均住院时间为8天。未观察到骨或软组织感染。只有1例患者在延长后出现天线系统刺激和疼痛,去除天线后完全康复。我们的结果表明,这种方法可以减少通常与外固定器相关的困难。它还能对机械轴偏差患者进行良好的角度矫正。这些特点加上较短的住院时间,使其成为青少年患者肢体延长的一种有前景的方法。

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