Zheng Xuejian, Qin Sihe, Shi Lei, Guo Baofeng, Zhao Jun, Yin Haiyang
Department of Orthopedic Surgery, Rehabilitation Hospital Affiliated to National Research Center for Rehabilitation AIDS, Beijing, 100176, P. R. China.
Department of Orthopedics, Chuiyangliu Hospital Affiliated to Tsinghua University, Beijing, 100022, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Feb 15;37(2):157-161. doi: 10.7507/1002-1892.202210072.
To investigate the surgical method and preliminary effectiveness of Ilizarov technique in the treatment of lower limb deformity caused by achondroplasia.
The clinical data of 38 patients with lower limb deformity caused by achondroplasia treated by Ilizarov technique between February 2014 and September 2021 were retrospectively analyzed. There were 18 males and 20 females, the age ranged from 7 to 34 years, with an average of 14.8 years. All patients presented with bilateral knee varus deformity. The preoperative varus angles was (15.2±4.2)°, and knee society score (KSS) was 61.8±7.2. Nine of these patients underwent tibia and fibula osteotomy, 29 cases underwent tibia and fibula osteotomy and bone lengthening at the same time. Full-length bearing position X-ray films of bilateral lower limbs were taken to measure the bilateral varus angles, analyze the healing index, and record the occurrence of complications. KSS score was used to evaluate the improvement of knee joint function before and after operation.
All 38 cases were followed up 9-65 months, with an average of 26.3 months. Needle tract infection occurred in 4 cases and needle tract loosening occurred in 2 cases after operation, which were improved after symptomatic treatment such as dressing change, Kirschner wire change, and oral antibiotics, and no neurovascular injury occurred in all patients. The external fixator was worn for 3-11 months after operation, with an average of 7.6 months, and the healing index was 43-59 d/cm, with an average of 50.3 d/cm. At last follow-up, the leg was 3-10 cm longer, with an average of 5.5 cm. The varus angles was (1.5±0.2)° and the KSS score was 93.7±2.6, which significantly improved when compared with those before operation ( <0.05).
Ilizarov technique is a safe and effective method for the treatment of short limb with genu varus deformity caused by achondroplasia, which can improve the quality of life of patients.
探讨伊里扎洛夫技术治疗软骨发育不全所致下肢畸形的手术方法及初步疗效。
回顾性分析2014年2月至2021年9月采用伊里扎洛夫技术治疗的38例软骨发育不全所致下肢畸形患者的临床资料。其中男性18例，女性20例，年龄7～34岁，平均14.8岁。所有患者均表现为双侧膝内翻畸形。术前内翻角度为(15.2±4.2)°，膝关节协会评分(KSS)为61.8±7.2。其中9例患者行胫腓骨截骨术，29例患者同时行胫腓骨截骨术及骨延长术。拍摄双下肢全长负重位X线片，测量双侧内翻角度，分析愈合指数，并记录并发症的发生情况。采用KSS评分评估手术前后膝关节功能的改善情况。
38例患者均获随访9～65个月，平均26.3个月。术后发生针道感染4例，针道松动2例，经换药、更换克氏针及口服抗生素等对症治疗后好转，所有患者均未发生神经血管损伤。外固定架术后佩戴3～11个月，平均7.6个月，愈合指数为43～59 d/cm，平均50.3 d/cm。末次随访时，下肢延长3～10 cm，平均5.5 cm。内翻角度为(1.5±0.2)°，KSS评分为93.7±2.6，与术前比较差异有统计学意义(<0.05)。
伊里扎洛夫技术是治疗软骨发育不全所致短肢膝内翻畸形的一种安全有效的方法，可提高患者的生活质量。
