Schoch Jennifer J, Schoch Bradley S, Werthel Jean David, McIntosh Amy L, Davis Dawn M R
Department of Dermatology, University of Florida, Gainesville, Florida.
Department of Orthopedic Surgery, University of Florida, Gainesville, Florida.
Pediatr Dermatol. 2018 Jan;35(1):43-46. doi: 10.1111/pde.13336. Epub 2017 Nov 9.
Linear morphea of the limb primarily affects children, and extracutaneous manifestations are common. Orthopedic surgeons are often essential in the care of patients with linear morphea, yet there are few reports outlining specific orthopedic complications in this population. We sought to improve the understanding of orthopedic complications in linear morphea of the limb. Between 1999 and 2014, 51 children were evaluated for linear morphea of an extremity. Twenty-six (51%) had documented orthopedic manifestations. Outcome measures included limb length discrepancy, angular malalignment, limb atrophy, and orthopedic surgical intervention. Joint contractures were most common, affecting 88% of patients, followed by limb atrophy, angular deformity, and limb length discrepancy; 14% required surgical intervention. Despite the use of systemic immunosuppressive therapy in many patients, approximately half of patients with linear morphea of an extremity have orthopedic disease. Early orthopedist involvement is crucial to improve limb alignment and preserve function.
肢体线状硬皮病主要影响儿童，且常伴有皮肤外表现。骨科医生在肢体线状硬皮病患者的治疗中往往至关重要，但很少有报告概述该人群的具体骨科并发症。我们旨在增进对肢体线状硬皮病骨科并发症的了解。1999年至2014年间，对51例患有肢体线状硬皮病的儿童进行了评估。其中26例（51%）有记录在案的骨科表现。观察指标包括肢体长度差异、成角畸形、肢体萎缩和骨科手术干预。关节挛缩最为常见，影响了88%的患者，其次是肢体萎缩、角形畸形和肢体长度差异；14%的患者需要手术干预。尽管许多患者使用了全身免疫抑制治疗，但约一半的肢体线状硬皮病患者仍患有骨科疾病。早期骨科医生的参与对于改善肢体对线和保留功能至关重要。
