Depaoli Alessandro, Magnani Marina, Casamenti Agnese, Cerasoli Tosca, Ramella Marco, Menozzi Grazia Chiara, Mordenti Marina, Rocca Gino, Trisolino Giovanni
Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy.
Children (Basel). 2023 Sep 22;10(10):1586. doi: 10.3390/children10101586.
The use of external fixators (EFs) for lower limb lengthening is common for treating lower limb length discrepancy (LLD) in children. The concern at present revolves around extended treatment times, with some suggesting a healing index (HI) > 45 days/cm as a major complication. The aim of this study is to assess the factors affecting bone healing and treatment duration in children who undergo limb lengthening for LLD using circular EFs. A total of 240 lengthening procedures on 178 children affected by congenital or acquired LLDs (mean age at surgery 13.8 ± 2.8 years) were retrospectively evaluated. Complications according to Lascombes' classification and treatment duration factors were analyzed. Mean HI was 57 ± 25 days/cm for the femur and 55 ± 24 days/cm for the tibia, with an HI > 45 days/cm in 64% of the procedures. A total of 189 procedures (79%) reported complications; 85 had an HI > 45 days/cm as the sole complication. While reducing the frame time is crucial, revising the classifications is necessary to avoid the overestimation of complications.
使用外固定器（EFs）进行下肢延长在治疗儿童下肢长度差异（LLD）中很常见。目前的关注点集中在延长的治疗时间上，一些人认为愈合指数（HI）> 45天/厘米是一个主要并发症。本研究的目的是评估使用环形EFs对因LLD接受肢体延长的儿童的骨愈合和治疗持续时间的影响因素。对178例患有先天性或后天性LLD的儿童（手术时平均年龄13.8±2.8岁）进行的总共240次延长手术进行了回顾性评估。分析了根据拉斯孔贝斯分类法的并发症和治疗持续时间因素。股骨的平均HI为57±25天/厘米，胫骨为55±24天/厘米，64%的手术中HI> 45天/厘米。总共189例手术（79%）报告有并发症；85例以HI> 45天/厘米作为唯一并发症。虽然减少固定时间至关重要，但有必要修订分类以避免对并发症的高估。
