Shadi Milud, Musielak Bartosz, Koczewski Paweł, Janusz Piotr
Department of Spine Disorders and Pediatric Orthopedics, Poznan University of Medical Sciences, ul. 28 czerwca 1956r nr 135, 61-545, Poznan, Poland.
Department of Pediatric Orthopedics and Traumatology, Poznan University of Medical Sciences, Poznan, Poland.
Int Orthop. 2018 Feb;42(2):419-426. doi: 10.1007/s00264-017-3632-x. Epub 2017 Sep 9.
Although humeral lengthening in patients with achondroplasia is an accepted procedure for improving functional status, there is still a paucity of information about the effectiveness of the method. Therefore, the aim of this study was to evaluate the efficacy and safety of humeral lengthening using monolateral fixators in patients with achondroplasia and unilateral shortening.
Twenty-one patients (31 humeri) were included in this study. The study group consisted of eight patients with achondroplasia (16 segments). The control group consisted of 13 patients with post-septic shortening of the humerus (15 segments). All subjects underwent distraction osteogenesis with the use of a monolateral fixator.
The mean lengthening in the patients with achondroplasia was 8.29 cm, whereas in the control group it was 7.34 cm (p = 0.1677). The mean lengthening percentage in the patients with achondroplasia (50% of the initial length of the humerus) was significantly greater than in the control group (33% of the initial length of the humerus) (p = 0.0007). The mean healing index was 24.8 days/cm in the patients with achondroplasia and 28.56 days/cm in the control group (p = 0.1832). The overall complication rates for the achondroplastic and post-septic patients were, respectively, 175% and 160% (p = 0.1420).
Humeral lengthening with use of monolateral fixators in patients with achondroplasia is an efficient method. Although the segment lengthening percentage is significantly greater in patients with achondroplasia than in patients with post-septic shortening of the humerus, the safety of this procedure is comparable.
虽然对于软骨发育不全患者进行肱骨延长术是一种公认的改善功能状态的手术，但关于该方法有效性的信息仍然匮乏。因此，本研究的目的是评估使用单侧固定器对软骨发育不全且单侧肱骨缩短患者进行肱骨延长术的疗效和安全性。
本研究纳入了21例患者（31侧肱骨）。研究组包括8例软骨发育不全患者（16个节段）。对照组包括13例肱骨感染后缩短患者（15个节段）。所有受试者均使用单侧固定器进行牵张成骨。
软骨发育不全患者的平均延长长度为8.29 cm，而对照组为7.34 cm（p = 0.1677）。软骨发育不全患者的平均延长百分比（占肱骨初始长度的50%）显著高于对照组（占肱骨初始长度的33%）（p = 0.0007）。软骨发育不全患者的平均愈合指数为24.8天/cm，对照组为28.56天/cm（p = 0.1832）。软骨发育不全患者和感染后患者的总体并发症发生率分别为175%和160%（p = 0.1420）。
对软骨发育不全患者使用单侧固定器进行肱骨延长术是一种有效的方法。虽然软骨发育不全患者的节段延长百分比显著高于肱骨感染后缩短患者，但该手术的安全性相当。
