Açan Ahmet Emrah, Demirhan Nihat, Başçi Onur, Gürsan Onur, Karakaşli Ahmet, Havitçioglu Hasan
Acta Orthop Belg. 2017 Jun;83(2):223-230.
The theoretical risk of medialisation of the knee joint and the lateral shift of the lower extremity mechanical axis, due to achievement of lengthening along the anatomical axis is present in the process of lengthening with elongation nails and the "lengthening over nail" technique. With this new technique described in this study we aimed to prove that lengthening over nail can be performed along the mechanical axis of the femur. Six lower-limb models were used to perform three different lengthening techniques. In group 1, lengthening was achieved along the anatomical axis with an external fixator. In group 2, the clamps of the external fixator were adjusted at 6° to achieve lengthening along the mechanical axis. In group 3, eight different sized nails were applied with an external fixator (angle adjustable clamps were at 6°) to achieve lengthening along the mechanical axis by LON technique. Photographs were taken after each cm of lengthening and the distance from the mechanical axis line were measured. The modified LON technique described in this study provided lengthening along the mechanical axis. One of the main advantages of the procedure described in our study is the chance for reconsideration and revision of unforeseen angulations and malalignments, via the help of the distal angular adjustable clamps; during the time of the surgery for external fixator removal before application of the poller screws.
在使用延长钉和“经钉延长”技术进行肢体延长的过程中，由于沿解剖轴实现延长，存在膝关节内移和下肢机械轴外移的理论风险。在本研究中描述的这项新技术中，我们旨在证明经钉延长可以沿着股骨的机械轴进行。使用六个下肢模型来执行三种不同的延长技术。在第1组中，使用外固定器沿解剖轴实现延长。在第2组中，将外固定器的夹具调整为6°，以沿机械轴实现延长。在第3组中，使用外固定器（角度可调夹具为6°）应用八个不同尺寸的钉子，通过经钉延长技术沿机械轴实现延长。每延长1厘米后拍照，并测量与机械轴线的距离。本研究中描述的改良经钉延长技术可沿机械轴进行延长。我们研究中描述的该手术的主要优点之一是，在应用拨钉器螺钉之前拆除外固定器的手术期间，借助远端角度可调夹具，有机会重新考虑和修正不可预见的成角和排列不齐情况。
