Benha University Hospitals, 11 Al Israa Al-Mohandeseen Street, Cairo, Egypt.
J Orthop Traumatol. 2020 Mar 5;21(1):3. doi: 10.1186/s10195-019-0541-3.
Limb lengthening continues to be a real challenge to both the patient and the orthopaedic surgeon. Although it is not a difficult operative problem, there is a long and exhausting postoperative commitment which can jeopardize early good results. I aim to review the history, evolution, biology, complications and current concepts of limb lengthening. Ilizarov's innovative procedure using distraction histeogenesis is the mainstay of all newly developing methods of treatment. The method of fixation is evolving rapidly from unilateral external fixator to ring fixator, computer assisted and finally lengthening intramedullary nails. The newly manufactured nails avoid many of the drawbacks of external fixation but they have their own complications. In general, the indications for limb lengthening are controversial. The indications have been extended from lower limb length inequality to upper extremity lengthening, including humeral, forearm and phalangeal lengthening. A wide range in frequency of complications is recorded in the English literature, which may reach up to 100% of cases treated. With developing experience, cosmetic lengthening has become possible using external or internal lengthening devices with an acceptable rate of problems.Level of evidence: V.
肢体延长仍然是患者和骨科医生面临的真正挑战。尽管这不是一个困难的手术问题，但术后需要长时间的艰苦康复，这可能会危及早期的良好效果。我旨在回顾肢体延长的历史、演变、生物学、并发症和当前的概念。伊里扎洛夫（Ilizarov）使用牵张成骨术的创新手术是所有新开发治疗方法的基础。固定方法正在从单侧外固定器快速发展为环形固定器、计算机辅助，最后是髓内钉延长。新制造的钉子避免了许多外固定的缺点，但它们也有自己的并发症。总的来说，肢体延长的适应证存在争议。适应证已经从下肢长度不等扩展到上肢延长，包括肱骨、前臂和指骨延长。在英文文献中记录了广泛的并发症发生率，在接受治疗的病例中可能高达 100%。随着经验的不断发展，使用外部或内部延长设备进行美容延长已经成为可能，其并发症发生率可以接受。证据水平：V。
