Wu Chi-Chuan
Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
J Orthop Surg (Hong Kong). 2017 Jan;25(1):2309499016684415. doi: 10.1177/2309499016684415.
Following far advancement of modern medicine and technology, functional disability in a certain type of sequelae of poliomyelitis may be effectively improved.
Eight consecutive adult patients with unilateral sequelae of poliomyelitis were treated. These patients had shortened lower extremity of an average of 4.8 cm (range, 4.0-5.5 cm) in the lesion side. Muscle power of the ipsilateral knee was nearly intact (grade 4 or 5) but the ankle extension was completely flaccid. The tibia was osteotomized and lengthened with external fixation. Consequently, all external fixators were converted to plates supplemented with autogenous corticocancellous bone graft and bone graft substitute. Ankle arthrodesis was performed concomitantly.
Seven patients were followed up for an average of 3.7 years (range, 2.2-5.4 years). All seven lengthened sites healed with an average union time of 3.9 months (range, 3.5-4.5 months) after plating. One ankle infection occurred. Gait function significantly improved by modified Mazur scoring evaluation ( p = 0.02). At the latest follow-up, all patients had a minimal or unnoticed limp in level walking.
The described combined techniques may be an excellent alternate for treating selected patients with sequelae of poliomyelitis. The procedure is not complex but the efficiency is extremely prominent.
随着现代医学和技术的不断进步，某种类型的小儿麻痹后遗症的功能障碍可得到有效改善。
对8例连续性成年单侧小儿麻痹后遗症患者进行治疗。这些患者病变侧下肢平均缩短4.8厘米（范围4.0 - 5.5厘米）。同侧膝关节肌力几乎正常（4级或5级），但踝关节背伸完全松弛。对胫骨进行截骨并采用外固定延长。随后，所有外固定器均转换为钢板，并辅以自体皮质松质骨移植和骨移植替代物。同时进行踝关节融合术。
7例患者平均随访3.7年（范围2.2 - 5.4年）。钢板固定后，所有7个延长部位均愈合，平均愈合时间为3.9个月（范围3.5 - 4.5个月）。发生1例踝关节感染。通过改良Mazur评分评估，步态功能显著改善（p = 0.02）。在最近一次随访时，所有患者在平路行走时跛行轻微或不明显。
所述联合技术可能是治疗特定小儿麻痹后遗症患者的一种极佳替代方法。该手术并不复杂，但效果极为显著。
