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应用伊里扎洛夫技术治疗血友病患者的膝关节屈曲挛缩

Management of knee flexion contracture in haemophilia with the Ilizarov technique.

作者信息

Zhai Jiliang, Weng Xisheng, Zhang Baozhong, Peng Huiming, Bian Yanyan

机构信息

Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Knee. 2019 Jan;26(1):201-206. doi: 10.1016/j.knee.2018.08.006. Epub 2018 Nov 8.

Abstract

BACKGROUND

There are limited reports about management of Knee flexion contracture (KFC) in haemophiliacs with Ilizarov technique. The aim of this study was to retrospectively analyzed the results of Ilizarov technique to treat KFC.

METHODS

Six patients with haemophilia A and one with haemophilia B were included in this study, with an average age of 17 years old. The mean preoperative KFC and flexion angle of the knee were 58 ± 21° (mean ± standard deviation) and 127 ± 12°, respectively. Preoperative HSS score (hospital for special surgery knee score) was 51 ± 4. The average time of follow-up was 39.3 ± 23.3 months.

RESULTS

All the patients achieved full correction of flexion contracture at the end of distraction and maintained at the last follow-up. The mean flexion angle at the end of distraction and at the last follow-up were 41 ± 35° and 38 ± 19° respectively, which were significantly lower than preoperative flexion angle. The mean HSS score at the end of distraction and at the last follow-up were 65 ± 4 and 64 ± 2 respectively, which were significantly higher than the preoperative HSS score. One patient suffered from transient numbness of left leg, and all the patients had loss of range of knee flexion at last follow-up.

CONCLUSIONS

Ilizarov is an effective and safe procedure to treat KFC in haemophiliacs. However, loss of knee flexion was the most common complication.

摘要

背景

关于采用伊里扎洛夫技术治疗血友病患者膝关节屈曲挛缩(KFC)的报道有限。本研究的目的是回顾性分析伊里扎洛夫技术治疗KFC的结果。

方法

本研究纳入6例甲型血友病患者和1例乙型血友病患者,平均年龄17岁。术前KFC平均角度和膝关节屈曲角度分别为58±21°(均值±标准差)和127±12°。术前HSS评分(特种外科医院膝关节评分)为51±4。平均随访时间为39.3±23.3个月。

结果

所有患者在牵张结束时均实现了屈曲挛缩的完全矫正,并在末次随访时得以维持。牵张结束时和末次随访时的平均屈曲角度分别为41±35°和38±19°,均显著低于术前屈曲角度。牵张结束时和末次随访时的平均HSS评分分别为65±4和64±2,均显著高于术前HSS评分。1例患者出现左腿短暂麻木,所有患者在末次随访时均有膝关节屈曲范围丢失。

结论

伊里扎洛夫技术是治疗血友病患者KFC的一种有效且安全的方法。然而,膝关节屈曲丢失是最常见的并发症。

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