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布尔内氏手术治疗成骨不全或先天性胫骨假关节患者长骨假关节——初步报告

Burnei's procedure in the treatment of long bone pseudarthrosis in patients having osteogenesis imperfecta or congenital pseudarthrosis of tibia - preliminary report.

作者信息

Vlad C, Georgescu I, Gavriliu T S, Hodorogea D I, El Nayef T, Dan D

机构信息

Maria Sklodowska Curie Children Emergency Hospital, Bucharest, Romania.

出版信息

J Med Life. 2012 Jun 12;5(2):215-21. Epub 2012 Jun 18.

Abstract

RATIONALE

given the recalcitrant behaviour of pseudarthrosis in osteogenesis imperfecta (OI) and congenital pseudarthrosis of the tibia (CPT), there is no ideal solution to treat such challenging deformities. The reconsideration of the already known principles, by using the modern technology, may generate new treatment methods.

AIM

the present paper presents the preliminary results of an original reconstruction procedure used to treat large bone defects in paediatric orthopaedics. A case series study, the surgical technique, complications and illustrative cases are presented.

METHODS AND RESULTS

3 cases of pseudarthrosis in OI and 2 cases of CPT were operated by using this technique. The principles of the method are to create an optimal osteoconductive and osteoinductive environment by using a bone autograft, bone allograft and bone graft substitutes and to provide a good stabilisation of the bones. We operated 3 patients with OI and 2 patients with CPT. Four patients had multiple previous surgeries. The follow-up period ranged from 3 to 28 months. Four of the five patients are able to ambulate independently at the moment this paper was written.

DISCUSSION

we believe that the present technique could be a reliable alternative to other procedures, especially in cases of repeated failures.

摘要

理论依据

鉴于成骨不全(OI)和先天性胫骨假关节(CPT)中假关节的顽固特性,对于治疗此类具有挑战性的畸形尚无理想的解决方案。通过运用现代技术重新审视已知原则,可能会产生新的治疗方法。

目的

本文介绍了一种用于治疗小儿骨科大骨缺损的原始重建手术的初步结果。呈现了一个病例系列研究、手术技术、并发症及示例病例。

方法与结果

使用该技术对3例OI假关节和2例CPT患者进行了手术。该方法的原则是通过使用自体骨移植、同种异体骨移植和骨移植替代物来营造一个最佳的骨传导和骨诱导环境,并为骨骼提供良好的固定。我们对3例OI患者和2例CPT患者进行了手术。4例患者之前接受过多次手术。随访期为3至28个月。在撰写本文时,5例患者中有4例能够独立行走。

讨论

我们认为,目前的技术可能是其他手术的可靠替代方法,尤其是在反复失败的病例中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aa1/3391886/baca2a7bde6d/JMedLife-05-215-g001.jpg

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