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[外骨骼加压固定及肢体短缩合并骨不连与畸形的延长术]

[External skeletal compression fixation and lengthening for shortened limb with non-union and deformity].

作者信息

Li Q H

机构信息

Department of Orthopedics, Southwest Hospital, Third Military Medical College, Chongqing.

出版信息

Zhonghua Wai Ke Za Zhi. 1990 Mar;28(3):161-5, 190.

PMID:2379426
Abstract

From Oct. 1982 to Dec. 1988, external skeletal compression fixator of half-ring sulcated type was used on 12 patients, aged 8 to 12, for treatment of shortened leg with non-union and bone defect, 7 of which were in tibia and 5 in femur. Scar tissue between fragment ends that interfered contact was cleared off for proper apposition and stability. 12 the non-union healed up in 4 to 6 months. In 5 patients with open epiphyses, distraction epiphysiolysis for lengthening was simultaneously performed in addition to compression at the non-union site; the lengths gained range from 4 to 13.5 cm, with an average of 9.8 cm. The lengthened region got repaired with in-growing bone in 5 to 10 months. In 7 patients with closed epiphyses; metamyseal osteotomy was done in combination for lengthening too; the lengths obtained were 3 to 16 cm, averaging 7.8 cm. The distraction gap was obliterated by in-growing bone in 4 to 16 months. In one case, metaphyseal osteotomy was performed on both ends of the tibia to get longer length to make up the tibial shaft defect of 8 cm; both non-union and lengthening segments healed up in 6 months. Neither neural nor vascular damage has occurred in any case, advantages and indications of the operation was discussed, and the surgical procedure was described.

摘要

1982年10月至1988年12月,采用半环槽式外骨骼加压固定器治疗12例8至12岁儿童下肢短缩伴骨不连和骨缺损,其中胫骨7例,股骨5例。清除骨折端间妨碍接触的瘢痕组织,以促进对位和稳定。12例骨不连均在4至6个月内愈合。5例骨骺未闭患者,除在骨不连部位加压外,同时行骨骺牵伸延长术;延长长度为4至13.5厘米,平均9.8厘米。延长区在5至10个月内由新生骨修复。7例骨骺已闭患者,同时行干骺端截骨延长术;延长长度为3至16厘米,平均为7.8厘米。牵伸间隙在4至16个月内由新生骨填充。1例胫骨两端行干骺端截骨以获得更长长度,以弥补8厘米的胫骨干缺损;骨不连和延长段均在6个月内愈合。所有病例均未发生神经和血管损伤,讨论了该手术的优点和适应证,并描述了手术步骤。

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