Yang Huaqing, Zhang Yaohua, Han Qinghai, Peng Aimin, Zheng Xuejian, Qin Sihe, Xia Hetao
Department of Orthopaedics, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, 100144,
Department of Orthopaedics, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, 100144, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Dec 15;32(12):1524-1529. doi: 10.7507/1002-1892.201804118.
To explore the effectiveness of minimally invasive osteotomy Ilizarov technique combined with intramedullary nail for femoral lengthening.
Seventy-one patients with femoral shortening deformity who met the selection criteria between January 2013 and June 2016 were randomly divided into trial group (36 cases were treated with minimally invasive osteotomy Ilizarov technique combined with intramedullary nail for femoral lengthening) and control group (35 cases were treated with simple Ilizarov technique for femoral lengthening). There was no significant difference in age, gender, causes of femoral shortening, length of femoral shortening, rate of femoral deformity between the two groups ( >0.05). The operation duration, intraoperative blood loss, lengthening rate, external fixation duration, frequency of pin tract infection, osteotomy healing time, and range of motion (ROM) of knee at 1 year after operation were recorded and compared between the two groups.
The patients of two groups were followed up 12-60 months (mean, 31 months). Pin tract infection occured in 8 cases (10 pins), including 1 case (1 pin) in the trial group and 7 cases (9 pins) in the control group. There was significant difference in the incidence of pin tract infection between the two groups ( =5.265, =0.022). All patients were cured by replacing the fixation pins, changing dressing actively, application of antibiotics, and adequate postoperative care. The operation duration, intraoperative blood loss, external fixation duration, osteotomy healing time, and ROM of knee at 1 year after operation of the trial group were superior to those of the control group, showing significant differences ( <0.05). There was no significant difference in the lengthening rate between the two groups ( =-1.581, =0.153).
The minimally invasive osteotomy Ilizarov technique combined with intramedullary nail in femoral lengthening increases the operation time, but the external fixation duration and incidence of pin tract infection are significantly reduced and the function of knee is significantly improved.
探讨微创截骨Ilizarov技术联合髓内钉治疗股骨延长的疗效。
选取2013年1月至2016年6月符合入选标准的71例股骨短缩畸形患者，随机分为试验组（36例采用微创截骨Ilizarov技术联合髓内钉治疗股骨延长）和对照组（35例采用单纯Ilizarov技术治疗股骨延长）。两组患者在年龄、性别、股骨短缩原因、股骨短缩长度、股骨畸形率方面比较，差异无统计学意义（>0.05）。记录并比较两组患者的手术时间、术中出血量、延长率、外固定时间、针道感染频率、截骨愈合时间及术后1年膝关节活动度（ROM）。
两组患者均随访12 - 60个月（平均31个月）。发生针道感染8例（10枚针），其中试验组1例（1枚针），对照组7例（9枚针）。两组针道感染发生率比较，差异有统计学意义（=5.265，=0.022）。经更换固定针、积极换药、应用抗生素及术后妥善护理，所有患者均治愈。试验组患者的手术时间、术中出血量、外固定时间、截骨愈合时间及术后1年膝关节ROM均优于对照组，差异有统计学意义（<0.05）。两组延长率比较，差异无统计学意义（=-1.581，=0.153）。
微创截骨Ilizarov技术联合髓内钉治疗股骨延长虽增加了手术时间，但显著缩短了外固定时间，降低了针道感染发生率，且显著改善了膝关节功能。
