Qin Sihe, Guo Baofeng, Wang Yilan
Department of Orthopedic Surgery, Rehabilitation Hospital of the National Research Center for Rehabilitation Technical Aids, Beijing, 100176, P.R.China.
Qinsihe Orthopedics Institute, Beijing, 100010, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Nov 15;35(11):1380-1383. doi: 10.7507/1002-1892.202107092.
To analyze the characteristics of patients with secondary lower limb deformity of spina bifida based on the QIN Sihe Orthopedic Surgery Case Data, and provide the references for clinical research, diagnosis, and treatment.
A clinical data of 1 012 patients with secondary lower limb deformity of spina bifida between October 12, 1986 and December 31, 2020 selected from QIN Sihe Orthopedic Surgery Case Data was retrospectively analyzed. Among them, 231 cases (22.83%) had undergone orthopedic surgery for lower extremity deformities in other hospitals. The gender, age at surgery, indicators related to spina bifida (deformity side, comorbidity, sensory disturbance level), and information related to surgery (operating time, surgical site, postoperative fixation method) were analyzed.
Of the 1012 patients, 457 were males and 555 were females. The age was 3-51 years at the time of surgery, with a median of 18.0 years; among them, the 15-30 years old group had the most patients, accounting for 53.16%. Most deformities involved both lower limbs (652 cases, 64.43%). There were 111 cases of ulcers in the weight-bearing area of the foot, 265 cases of gatism, 554 cases of sensory disturbance, and 85 cases of abnormal hair on the waist. From 2010 to 2019, there were significantly more patients undergoing surgery than before 2010, reaching 61.17%. Sensory disturbances mostly occurred in the ankle and foot. A total of 1 149 sites were treated with surgery, of which the most ankle joint deformities were corrected by surgery, accounting for 84.33%. The main fixation methods after orthopedic surgery were external fixation, including Ilizarov external fixation (442 cases), combined external fixation (315 cases), and plaster fixation (189 cases).
Spina bifida can be secondary to severe deformities of the lower limbs, mainly in the ankles. Common complications include ulcers in the weight-bearing area, dysfunction of urine and feces, and sensory disturbances; external fixation is the main method of fixation after surgery.
基于秦泗河矫形外科病例资料，分析脊柱裂继发下肢畸形患者的特点，为临床研究、诊断及治疗提供参考。
回顾性分析从秦泗河矫形外科病例资料中选取的1986年10月12日至2020年12月31日期间1012例脊柱裂继发下肢畸形患者的临床资料。其中，231例（22.83%）曾在其他医院接受过下肢畸形矫形手术。分析患者的性别、手术年龄、与脊柱裂相关的指标（畸形侧、合并症、感觉障碍平面）以及与手术相关的信息（手术时间、手术部位、术后固定方式）。
1012例患者中，男性457例，女性555例。手术时年龄为3至51岁，中位数为18.0岁；其中，15至30岁组患者最多，占53.16%。多数畸形累及双下肢（652例，64.43%）。足部负重区溃疡111例，大小便失禁265例，感觉障碍554例，腰部毛发异常85例。2010年至2019年接受手术的患者明显多于2010年以前，占61.17%。感觉障碍多发生在踝关节和足部。共手术治疗1149个部位，其中手术矫正踝关节畸形最多，占84.33%。矫形手术后主要固定方式为外固定，包括伊里扎洛夫外固定（442例）、组合外固定（315例）和石膏固定（189例）。
脊柱裂可继发严重下肢畸形，主要在踝关节。常见并发症包括负重区溃疡、大小便功能障碍及感觉障碍；外固定是术后主要固定方式。
