Karski T, Warda E
Z Orthop Ihre Grenzgeb. 1986 Jan-Feb;124(1):13-8. doi: 10.1055/s-2008-1044516.
So-called pseudarthrosis of the lower leg is a rare condition whose treatment entails major therapeutic problems. The first symptoms of this disease are structural changes thinning, and sclerosis of the tibia and fibula, as well as varus and antecurvation malposition? of the axis. In all of the authors' patients the pseudarthrosis occurred as a secondary phenomenon, three times in attempts to correct the lower leg axis surgically; in two children spontaneous fractures occurred due to fatigue and in two others after stumbling. In all seven of the surgically treated children and in three of the six in the outpatient group café-au-lait spots were seen. The neurofibromatosis was also confirmed by histological examinations in all of the surgically treated children. Not only the views concerning etiology, but also therapy have changed. Our present treatment method is undoubtedly a success as compared to that used on our first patients. On the basis of our surgical experience so far we can recommend the following method: resection of the pseudarthrosis with removal of all pathologically changed tissue (also by fraising), insertion of Küntscher nails from the heel to the tibia, adequate covering of the pseudarthrosis location with spongiosa grafts from the pelvic ridge. If necessary, the intervention should be repeated.
所谓小腿假关节是一种罕见病症，其治疗存在重大治疗难题。该疾病的最初症状是胫腓骨结构改变（变薄和硬化）以及轴的内翻和前弯畸形。在所有作者的患者中，假关节均作为继发现象出现，3次发生在手术矫正小腿轴的尝试过程中；2名儿童因疲劳出现自发性骨折，另外2名儿童在绊倒后出现骨折。在接受手术治疗的所有7名儿童以及门诊组6名患者中的3名身上发现了牛奶咖啡斑。通过组织学检查在所有接受手术治疗的儿童中也证实了神经纤维瘤病。不仅关于病因的观点发生了变化，治疗方法也有所改变。与我们最初治疗的患者所采用的方法相比，我们目前的治疗方法无疑是成功的。基于我们目前的手术经验，我们可以推荐以下方法：切除假关节并清除所有病理改变组织（也可通过锉磨），从足跟至胫骨插入克氏针，用来自髂嵴的松质骨移植充分覆盖假关节部位。如有必要，应重复该干预措施。
