Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Bay Area Foot and Ankle Medical Clinic, San Jose, USA.
BMC Public Health. 2023 Mar 27;23(1):567. doi: 10.1186/s12889-023-15470-9.
Neurogenic limb deformity disorder (NLDD) refers to limb deformity disorders caused by various neurogenic disorders. However, there are no studies to systematically summarize and analyze these diseases in China, and we first proposed the concept of NLDD. We describe the epidemiological characteristics of NLDD in China based on the largest case database of limb orthopedics in China.
This study analyzed parameters from the Qin Sihe Orthopedic Surgery Case Data (QSHOSCD). The database is based on the Rehabilitation Hospital affiliated to National Research Center for Rehabilitation, which has collected nearly 37,000 patients to date and includes a wide variety of limb deformities. The types of diseases are summarized and classified for all patients studied. Statistical analysis was based on the type of etiology, age, regional distribution, and historical surgical volume. Partial outcomes were statistically analyzed separately by common diseases (polio and cerebral palsy) and rare diseases (37 other diseases).
From 1979 to 2019, 30,194 patients with NLDD were treated surgically for 39 neurogenic disorders. The male to female ratio was 1.48:1, the mean age was 19.65 years, and most patients (82.38%) were aged between 6 and 30 years. Patients included from 32 provinces and cities across China, mainly concentrated in populous central provinces and Heilongjiang Province. The peak of annual surgical procedures was from 1988 to 1994, and the number of annual surgical procedures for common diseases gradually decreased from 1994 onwards, but the trending is opposite for rare diseases.
This study is the first to demonstrate the disease types, population characteristics and incidence trends of NLDD in China. It suggests that the prevention and treatment of NLDD should focus on the adolescent population and enhance the treatment of neurogenic diseases that cause limb deformities. The growth and adaption of the Ilizarov technique and its practice in Chinese orthopedic benefits the treatment of neurogenic limb deformity disorders.
神经源性肢体畸形障碍（NLDD）是指由各种神经源性疾病引起的肢体畸形障碍。然而，目前在中国还没有研究系统地总结和分析这些疾病，我们首次提出了 NLDD 的概念。我们根据中国最大的肢体矫形病例数据库，描述了中国 NLDD 的流行病学特征。
本研究分析了秦泗河矫形外科病例数据库（QSHOSCD）的数据。该数据库是基于国家康复研究中心附属医院的康复医院建立的，迄今为止已收集了近 37000 名患者，包括各种肢体畸形。对所有研究患者的疾病类型进行了总结和分类。统计分析基于病因类型、年龄、地域分布和历史手术量。部分结果按常见疾病（脊髓灰质炎和脑瘫）和罕见疾病（其他 37 种疾病）分别进行了统计学分析。
1979 年至 2019 年，30194 例 NLDD 患者因 39 种神经源性疾病接受了手术治疗。男女比例为 1.48:1，平均年龄为 19.65 岁，82.38%的患者年龄在 6 至 30 岁之间。患者来自中国 32 个省、市，主要集中在人口大省和黑龙江省。年度手术量的高峰期在 1988 年至 1994 年，自 1994 年以来，常见疾病的年手术量逐渐减少，但罕见疾病的趋势则相反。
本研究首次展示了中国 NLDD 的疾病类型、人口特征和发病趋势。研究提示 NLDD 的防治应重点关注青少年人群，并加强对引起肢体畸形的神经源性疾病的治疗。伊利扎罗夫技术在中国骨科的成长和适应及其应用有利于神经源性肢体畸形障碍的治疗。
