Willegger Madeleine, Bouchard Maryse, Windhager Reinhard, Kolb Alexander, Chiari Catharina
Universitätsklinik für Orthopädie und Unfallchirurgie, Klinische Abteilung für Orthopädie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
Division of Orthopaedics, Hospital for Sick Children, Toronto, ON, Kanada.
Orthopade. 2022 May;51(5):415-432. doi: 10.1007/s00132-022-04219-8. Epub 2022 Mar 31.
The principals of growth arrest by epiphysiodesis and growth guidance by hemiepiphysiodesis are effective and powerful surgical techniques in pediatric orthopedics. These procedures can be used to correct leg length discrepancies as well as sagittal, coronal and oblique deformities. A differentiation is made between temporary and permanent techniques. The most significant advantage is that these techniques are minimally invasive and have low complication rates compared to acute osteotomy and gradual deformity correction. For optimal outcome an exact preoperative planning is needed to ensure accurate timing of the procedure, especially when permanent epiphysiodesis techniques are used. Although epiphysiodesis and hemiepiphysiodesis around the pediatric knee are most frequently used and can be considered the gold standard treatment of coronal plane deformities and leg length discrepancies, novel techniques for the hip and ankle are increasingly being performed. The successful clinical results with low complications support the broad use of hemiepiphysiodesis and epiphysiodesis for a variety of indications in the growing skeleton with deformities and leg length differences.
骺板阻滞术导致生长停滞以及半骺板阻滞术引导生长的原理，是小儿骨科中有效且强大的手术技术。这些手术可用于纠正下肢长度差异以及矢状面、冠状面和斜形畸形。手术技术可分为临时性和永久性两类。最显著的优势在于，与急性截骨术和逐步矫正畸形相比，这些技术具有微创性且并发症发生率低。为获得最佳效果，需要进行精确的术前规划，以确保手术时机准确，尤其是在使用永久性骺板阻滞术时。尽管小儿膝关节周围的骺板阻滞术和半骺板阻滞术最为常用，可被视为冠状面畸形和下肢长度差异的金标准治疗方法，但针对髋部和踝部的新技术也越来越多地被应用。低并发症的成功临床结果支持广泛使用半骺板阻滞术和骺板阻滞术来治疗生长中骨骼的各种畸形和下肢长度差异适应症。
