Radler Christof
Abteilung für Kinderorthopädie und Fußchirurgie, Orthopädisches Spital Speising GmbH, Speisinger Str. 109, 1130, Wien, Österreich.
Unfallchirurg. 2019 Jan;122(1):33-43. doi: 10.1007/s00113-018-0593-5.
Fractures in childhood can result in malalignment and/or leg shortening due to insufficient reduction, malunion or injury to the growth plate.
Different types of posttraumatic deformities around the knee as well as the diagnostic approach and correction are discussed.
While deformities without shortening can often be corrected during surgery with internal fixation, limb shortening with or without malalignment has to be treated with external fixation or internal lengthening nails.
Modern six-axis external fixators enable simultaneous lengthening and axial correction in all planes in patients from childhood onwards. A correction using lengthening nails is possible at the end of growth or if the physis has already been closed by trauma.
Precise analysis of the deformity and leg length discrepancy is necessary to select the best point in time and the right surgical procedure and hardware for correction.
儿童骨折可能因复位不充分、畸形愈合或生长板损伤而导致对线不良和/或腿部缩短。
讨论膝关节周围不同类型的创伤后畸形以及诊断方法和矫正方法。
无缩短的畸形通常可在手术中通过内固定矫正,而伴有或不伴有对线不良的肢体缩短则必须采用外固定或内延长钉治疗。
现代六轴外固定器能够从儿童期起就对患者在所有平面上同时进行延长和轴向矫正。在生长结束时或如果骨骺已经因创伤而闭合,则可以使用延长钉进行矫正。
精确分析畸形和腿长差异对于选择最佳时机以及合适的手术方法和矫正器械至关重要。