Bukva Bojan, Vrgoč Goran, Rakovac Ivan, Dučić Siniša, Sindik Joško, Čoklo Miran, Marinović Marin, Bakota Bore
Department of Paediatric Orthopaedic Surgery, University Children's Hospital, Belgrade, Serbia.
Department of Orthopaedic Surgery, University Hospital "Sveti Duh", Zagreb, Croatia.
Injury. 2015 Nov;46 Suppl 6:S48-51. doi: 10.1016/j.injury.2015.10.058. Epub 2015 Nov 21.
The purpose of this retrospective study was to evaluate the complications associated with leg lengthening in children treated with the Ilizarov external fixator (IEF) and compare them between two groups of patients: one group was treated using an IEF alone and the other group was treated using an IEF in association with intramedullary alignment (IA).
The study was performed at the University Children's Hospital in Belgrade, Serbia during a fourteen-year period (from 2000 to 2014). Complications occurred in 73 paediatric patients who underwent the leg lengthening procedure. Complications were classified according to the Caton classification and compared between two groups. Group I comprised 39 patients who underwent the limb lengthening procedure using IEF alone. Group II consisted of 34 patients who were treated with the combination of IEF and IA using two Kirschner wires (K-wires) or Titanium Elastic Nails (TEN). The duration of hospital treatment was also compared between the two groups and the impact of the type of IA on the occurrence of complications was assessed.
There was a high rate of complications in patients treated using an IEF compared with those treated using the combination of IEF and IA, but there was no statistically significant difference between the two groups. There was a statistically significant difference in the duration of initial hospitalisation between the two groups, particularly when comparing TEN usage in IA. A comparison of the group of patients treated using an IEF in association with K-wires and patients treated using IEF and TEN showed there was no statistically significant difference in complication rate and duration of initial hospitalisation.
IA has multiple advantages as a method of treatment of leg length inequality. The major effect of applying IA in association with a circular IEF is significantly reduced complication rate and duration of initial hospitalisation, particularly when using TEN as a method of IA. This method of treatment also decreases hospital costs.
本回顾性研究的目的是评估使用伊里扎洛夫外固定器（IEF）治疗儿童腿部延长相关的并发症，并在两组患者之间进行比较：一组仅使用IEF治疗，另一组使用IEF联合髓内对线（IA）治疗。
该研究于14年期间（2000年至2014年）在塞尔维亚贝尔格莱德大学儿童医院进行。73例接受腿部延长手术的儿科患者出现了并发症。并发症根据卡顿分类法进行分类，并在两组之间进行比较。第一组包括39例仅使用IEF进行肢体延长手术的患者。第二组由34例使用两根克氏针（K线）或钛弹性钉（TEN）进行IEF和IA联合治疗的患者组成。还比较了两组的住院治疗时间，并评估了IA类型对并发症发生的影响。
与使用IEF和IA联合治疗的患者相比，使用IEF治疗的患者并发症发生率较高，但两组之间无统计学显著差异。两组之间初始住院时间有统计学显著差异，特别是在比较IA中TEN的使用情况时。比较使用IEF联合K线治疗的患者组和使用IEF和TEN治疗的患者组，并发症发生率和初始住院时间无统计学显著差异。
IA作为治疗腿长不等的方法有多种优势。将IA与环形IEF联合应用的主要效果是显著降低并发症发生率和初始住院时间，特别是在使用TEN作为IA方法时。这种治疗方法还可降低医院成本。
