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临时半骨骺阻滞术治疗膝关节特发性及病理性畸形:355例回顾性分析

Temporary hemiepiphysiodesis for correcting idiopathic and pathologic deformities of the knee: A retrospective analysis of 355 cases.

作者信息

Radtke Kerstin, Goede Fabian, Schweidtmann Katharina, Schwamberger Tanja, Calliess Tilman, Fregien Bastian, Stukenborg-Colsman Christina, Ettinger Max

机构信息

Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany.

Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany.

出版信息

Knee. 2020 Jun;27(3):723-730. doi: 10.1016/j.knee.2020.04.024. Epub 2020 May 18.

DOI:10.1016/j.knee.2020.04.024
PMID:32563429
Abstract

BACKGROUND

Hemiepiphysiodesis is a well-established treatment option in cases of pathologic deformities and leg discrepancies during evolution. The aim of this study was to evaluate the postoperative angular measurement, correction correlated with age at operation time, and postoperative complication rate.

MATERIAL AND METHODS

A total of 355 patients were treated with 887 8-plates between April 2007 and January 2013. Their mean age was 12.18 years (range four to 16 years), and the mean time to axis correction was 17.32 months (range two to 62 months). We analysed the entire population and also performed subgroup analyses for idiopathic, pathologic, varus, valgus and leg length discrepancy.

RESULTS

The mean durations (time from (hemi-) epiphysiodesis to implant removal) in the idiopathic and pathologic groups were 13.24 and 21.3 months, respectively. The time to implant removal was 18.39 months for idiopathic varus deformities and 11.07 months for idiopathic valgus deformities. For the pathologic deformity group it was 24.9 and 20 months in the varus and valgus subgroups, respectively.

CONCLUSIONS

Hemiepiphysiodesis is a well-established treatment option to correct angular deformities. The rate of correction was slower and less successful in pathologic deformities and for leg length discrepancies. This suggests that earlier intervention is appropriate for these patients. A higher body mass index (BMI) was observed for valgus deformity, but no correlation was present between BMI and durability.

摘要

背景

半骨骺阻滞术是治疗发育过程中病理性畸形和下肢不等长的一种成熟治疗方法。本研究的目的是评估术后角度测量、与手术时年龄相关的矫正情况以及术后并发症发生率。

材料与方法

2007年4月至2013年1月期间,共有355例患者接受了887块8字钢板治疗。他们的平均年龄为12.18岁(范围4至16岁),平均轴向矫正时间为17.32个月(范围2至62个月)。我们分析了全部人群,并对特发性、病理性、内翻、外翻和下肢长度不等进行了亚组分析。

结果

特发性和病理性组的平均持续时间(从(半)骨骺阻滞术到取出植入物的时间)分别为13.24个月和21.3个月。特发性内翻畸形取出植入物的时间为18.39个月,特发性外翻畸形为11.07个月。对于病理性畸形组,内翻和外翻亚组分别为24.9个月和20个月。

结论

半骨骺阻滞术是矫正角度畸形的一种成熟治疗方法。在病理性畸形和下肢长度不等的情况下,矫正速度较慢且成功率较低。这表明对这些患者进行早期干预是合适的。外翻畸形患者的体重指数(BMI)较高,但BMI与耐久性之间不存在相关性。

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