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在生长阶段,长骨的旋转畸形可通过旋转引导生长来矫正。

Rotational deformities of the long bones can be corrected with rotationally guided growth during the growth phase.

作者信息

Cobanoglu Mutlu, Cullu Emre, Kilimci Figen Sevil, Ocal Mehmet Kamil, Yaygingul Rahime

机构信息

a Department of Orthopedics and Traumatology, Faculty of Medicine .

b Department of Anatomy, Faculty of Veterinary Medicine .

出版信息

Acta Orthop. 2016 Jun;87(3):301-5. doi: 10.3109/17453674.2016.1152450. Epub 2016 Feb 22.

Abstract

Background and purpose - Coronal and sagittal plane long bone deformities can be corrected with guided growth, whereas transverse plane rotational deformities require osteotomy and internal or external fixation. We investigated whether rotational changes can be introduced with the plating technique. Methods - 45 rabbits (6 weeks old) were divided into 3 groups. The unoperated right tibia was used as control. In groups 1 and 3, two plates were placed obliquely to the long axis and in different directions. In group 2, a sham operation was performed with screws. Animals in groups 1 and 2 were followed for 4 weeks. In group 3 the implants were removed 4 weeks after the operation to observe rebound effect, and the animals were followed for another 4 weeks. The tibial torsion was assessed on computed tomography (CT). External rotation was accepted as a negative value. Results - In group 1, mean torsion was -20° (SD 7.9) in the right tibia and -2.9° (SD 7.2) in the left tibia (p < 0.001). In group 2, mean torsion was -23° (SD 4.9) in the right tibia and -26° (SD 6.5) in the left tibia (p = 0.2). In group 3, mean torsion was -21° (SD 6.3) in the right tibia and -9.5° (SD 5.3) in the left tibia (p < 0.001). Intergroup evaluation for left torsion showed a significant difference between group 2 and the other groups (p < 0.001). When the rebound effect was evaluated, there was no statistically significant difference between groups 1 and 3 (p = 0.08). Interpretation - A rotational change was attained with this technique. Although a rebound effect was seen after implant removal, it did not reach statistical significance. The final rotational change remained constant.

摘要

背景与目的——冠状面和矢状面的长骨畸形可通过引导生长进行矫正,而横断面的旋转畸形则需要截骨术及内固定或外固定。我们研究了通过钢板技术是否可以引入旋转改变。方法——45只6周龄的兔子被分为3组。未手术的右胫骨用作对照。在第1组和第3组中,两块钢板倾斜于长轴并以不同方向放置。在第2组中,仅拧入螺钉进行假手术。第1组和第2组的动物随访4周。第3组在术后4周取出植入物以观察反弹效应,然后对动物再随访4周。通过计算机断层扫描(CT)评估胫骨扭转情况。外旋被记为负值。结果——在第1组中,右胫骨平均扭转角度为-20°(标准差7.9),左胫骨为-2.9°(标准差7.2)(p<0.001)。在第2组中,右胫骨平均扭转角度为-23°(标准差4.9),左胫骨为-26°(标准差6.5)(p = 0.2)。在第3组中,右胫骨平均扭转角度为-21°(标准差6.3),左胫骨为-9.5°(标准差5.3)(p<0.001)。对左胫骨扭转的组间评估显示,第2组与其他组之间存在显著差异(p<0.001)。在评估反弹效应时,第1组和第3组之间无统计学显著差异(p = 0.08)。解读——通过该技术可实现旋转改变。尽管在取出植入物后观察到了反弹效应,但未达到统计学显著性。最终的旋转改变保持稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be80/4900079/4d5fd06013e4/iort-87-301.01.jpg

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