Department of Pediatric Orthopaedics and Traumatology, Nancy Teaching Hospital Center, Brabois Hospital Group, Children hospital, 5, allée du Morvan, 54511 Vandœuvre, France.
Orthop Traumatol Surg Res. 2012 Jun;98(4):376-82. doi: 10.1016/j.otsr.2012.01.007. Epub 2012 May 2.
Most of the techniques for forearm lengthening involve external fixation to achieve stability and provide progressive distraction. We introduce the use of elastic stable intramedullar nailing (ESIN) in combination with external circular assembly for the procedure. The purpose of this prospective study was to compare Ilizarov's classical technique with this combined technique.
Fifty-seven patients, with forearm length discrepancies or deformities either congenital or acquired, were prospectively followed-up. Patients were divided in two groups: 35 had only external fixation, and 22 had external fixation-ESIN combined techniques. Patients were assessed for clinical and radiographic outcome with a mean follow-up of 21 months after external device removal.
Overall lengthening was 45.0mm. Healing index (HI) was 22.2d/cm with the combined technique, and 32.0 d/cm with external fixation. HI was 30% better when ESIN was used, for congenital and for overall cases. Combined technique has a lower complication rate.
Although forearm lengthening still remains a time-consuming procedure, ESIN can shorten external fixator wearing time. No additional complication occurred and bony complications seem to be limited by the nails. We recommend this technique, which we now use for most of our patients undergoing limb lengthening.
Level IV.
大多数前臂延长技术都涉及外固定以获得稳定性并提供渐进式分离。我们介绍了弹性稳定髓内钉（ESIN）与外圆组件结合使用的方法。本前瞻性研究的目的是比较伊里扎洛夫经典技术与联合技术。
57 例前臂长度差异或畸形患者（先天性或获得性）前瞻性随访。患者分为两组：35 例仅接受外固定，22 例接受外固定-ESIN 联合治疗。在去除外固定装置后平均随访 21 个月，对患者进行临床和影像学结果评估。
总延长长度为 45.0mm。联合技术的愈合指数（HI）为 22.2d/cm，外固定为 32.0d/cm。与外固定相比，使用 ESIN 时 HI 提高了 30%，无论是先天性病例还是整体病例。联合技术的并发症发生率较低。
尽管前臂延长仍然是一个耗时的过程，但 ESIN 可以缩短外固定器的佩戴时间。没有发生额外的并发症，且骨并发症似乎受到钉子的限制。我们推荐这种技术，现在我们将其用于大多数接受肢体延长的患者。
IV 级。
