Lin Dasheng, Zhai Wenliang, Lian Kejian, Ding Zhenqi
Department of Orthopedic Surgery, The Affiliated Southeast Hospital of Xiamen University, Orthopedic Center of People's Liberation Army, Zhangzhou - 363000, China.
Indian J Orthop. 2013 Jul;47(4):377-81. doi: 10.4103/0019-5413.114922.
Children with osteogenesis imperfecta (OI) can suffer from frequent fractures and limb deformities, resulting in impaired ambulation. Osteopenia and thin cortices complicate orthopedic treatment in this group. This study evaluates the clinical results of a bone splint technique for the treatment of lower limb deformities in children with type I OI. The technique consists of internal plating combined with cortical strut allograft fixation.
We prospectively followed nine children (five boys, four girls) with lower limb deformities due to type I OI, who had been treated with the bone splint technique (11 femurs, four tibias) between 2003 and 2006. The fracture healing time, deformity improvement, ambulation ability and complications were recorded to evaluate treatment effects.
At the time of surgery the average age in our study was 7.7 years (range 5-12 years). The average length of followup was 69 months (range 60-84 months). All patients had good fracture healing with an average healing time of 14 weeks (range 12-16 weeks) and none experienced further fractures, deformity, or nonunion. The fixation remained stable throughout the procedure in all cases, with no evidence of loosening or breakage of screws and the deformity and mobility significantly improved after surgery. Of the two children confined to bed before surgery, one was able to walk on crutches and the other needed a wheelchair. The other seven patients could walk without walking aids or support like crutches.
These findings suggest that the bone splint technique provides good mechanical support and increases the bone mass. It is an effective treatment for children with OI and lower limb deformities.
成骨不全（OI）患儿常发生频繁骨折和肢体畸形，导致行走功能受损。骨质减少和皮质变薄使该组患儿的骨科治疗复杂化。本研究评估一种骨夹板技术治疗Ⅰ型OI患儿下肢畸形的临床效果。该技术包括内固定钢板联合皮质支撑异体骨固定。
我们前瞻性地随访了9例因Ⅰ型OI导致下肢畸形的患儿（5例男孩，4例女孩），他们在2003年至2006年间接受了骨夹板技术治疗（11个股骨，4个胫骨）。记录骨折愈合时间、畸形改善情况、行走能力和并发症，以评估治疗效果。
手术时，我们研究中的患儿平均年龄为7.7岁（范围5 - 12岁）。平均随访时间为69个月（范围60 - 84个月）。所有患者骨折愈合良好，平均愈合时间为14周（范围12 - 16周），且无一例发生进一步骨折、畸形或骨不连。在所有病例中，整个过程中固定均保持稳定，没有螺钉松动或断裂的迹象，术后畸形和活动能力明显改善。术前卧床的2例患儿中，1例能够拄拐行走，另1例需要轮椅。其他7例患者无需拐杖等辅助器具或支撑即可行走。
这些结果表明，骨夹板技术提供了良好的机械支撑并增加了骨量。它是治疗OI患儿下肢畸形的一种有效方法。
