Department of Orthopedics and Trauma Surgery-Division for Orthopedics, Comprehensive Center for Pediatrics, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Vienna Bone and Growth Center, Vienna, Austria.
Wien Med Wochenschr. 2021 Apr;171(5-6):133-141. doi: 10.1007/s10354-021-00828-8. Epub 2021 Mar 18.
Painful orthopedic conditions associated with extreme tall stature and leg length discrepancy (LLD) include back pain and adopting bad posture. After failure of conservative treatment options, blocking of the growth plates (epiphysiodesis) around the knee emerged as gold standard in patients with tall stature and LLD in the growing skeleton. Surgical planning includes growth prediction and evaluation of bone age. Since growth prediction is associated with a certain potential error, adequate planning and timing of epiphysiodesis are the key for success of the treatment. LLD corrections up to 5 cm can be achieved, and predicted extreme tall stature can be limited. Percutaneous epiphysiodesis techniques are minimally invasive, safe and efficient methods with low complication rates. In general, a multidisciplinary approach should be pursued when treating children and adolescents with tall stature.
与极高身高和肢体长度差异(LLD)相关的骨科疼痛病症包括背痛和不良姿势。在保守治疗方案失败后,膝关节周围生长板(骺板融合术)阻断已成为生长骨骼中高身材和 LLD 患者的金标准。手术规划包括生长预测和骨龄评估。由于生长预测存在一定的潜在误差,因此骺板融合术的充分规划和时机是治疗成功的关键。可以实现高达 5cm 的肢体长度差异纠正,并限制预测的极端身高。经皮骺板融合术是一种微创、安全、有效的方法,并发症发生率低。一般来说,在治疗身材高大的儿童和青少年时,应采用多学科方法。