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临时半骨骺阻滞术治疗骨骼未成熟创伤后膝内翻畸形的疗效:27例回顾性研究

The effect of temporary hemiepiphysiodesis in the treatment of skeleton immature posttraumatic genu angular deformity: a retrospective study of 27 cases.

作者信息

Ding Jing, Zhu Ting, Jin Fang-Chun, Wu Zhen-Kai, Li Hai

机构信息

Department of Pediatric Orthopaedics, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1665, Kongjiang Road, Shanghai, 200092, China.

Clinical Research Unit, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.

出版信息

J Orthop Surg Res. 2019 Nov 21;14(1):381. doi: 10.1186/s13018-019-1426-0.

Abstract

BACKGROUND

The purpose of this study was to evaluate the effect, rate of angular correction, and complications of temporary hemiepiphysiodesis (TH) in the treatment of skeleton immature posttraumatic genu angular deformity.

METHODS

We retrospectively reviewed the records of 27 patients undergoing temporary hemiepiphysiodesis for the management of posttraumatic genu angular deformity. Based on the data from these patients, the rate of correction, effect of correction, length of the lower limbs, and complications were used as the outcome measures.

RESULTS

Outcome measurements were obtained from a chart review of medical records that included information about clinical evaluations. Fifteen boys and 12 girls, with an average age of 6.3 years, were included in the study. The average follow-up was 3.8 years (range, 1.9 to 5.9 years) after surgery. Complete correction was obtained in 24 patients, while partial correction was obtained in 3 patients. The mean rate of angular correction was 8.41°/year in distal femur and 15.19°/year in proximal tibia. One patient had recurrence of genu valgum. No leg length discrepancy was found in our patients.

CONCLUSION

Temporary hemiepiphysiodesis is a simple, effective, reliable, and reproducible method for the treatment of posttraumatic genu angular deformity, with fewer complications than osteotomy. Nevertheless, it is important to follow the rebound patient closely until skeletal maturity in our future work.

摘要

背景

本研究旨在评估临时半骨骺阻滞术(TH)治疗骨骼未成熟创伤后膝内翻畸形的效果、角度矫正率及并发症。

方法

我们回顾性分析了27例行临时半骨骺阻滞术治疗创伤后膝内翻畸形患者的病历。基于这些患者的数据,将矫正率、矫正效果、下肢长度及并发症作为观察指标。

结果

通过查阅包含临床评估信息的病历进行观察指标的测量。本研究纳入了15名男孩和12名女孩,平均年龄6.3岁。术后平均随访3.8年(范围1.9至5.9年)。24例患者获得完全矫正,3例患者获得部分矫正。股骨远端平均角度矫正率为每年8.41°,胫骨近端为每年15.19°。1例患者膝外翻复发。我们的患者中未发现下肢长度差异。

结论

临时半骨骺阻滞术是治疗创伤后膝内翻畸形的一种简单、有效、可靠且可重复的方法,并发症比截骨术少。然而,在我们未来的工作中,密切随访有反弹的患者直至骨骼成熟很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad22/6868743/8aa37c7027cf/13018_2019_1426_Fig1_HTML.jpg

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