Armagan Raffi, Kucukkaya Metin, Ozdemir Haci Mustafa
Department of Orthopedics and Traumatology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Türkiye.
Sisli Etfal Hastan Tip Bul. 2023 Jun 20;57(2):263-271. doi: 10.14744/SEMB.2023.03185. eCollection 2023.
Complications are common in the treatment of lower extremity congenital or acquired deformities by Ilizarov method. The results to be obtained vary in specific patient groups. In this study, deformities who developed before the age of 16 were compared with those developed after this age regardless of the type of aetiology, in terms of results obtained, treatment durations and complications encountered.
53 bone deformities with an average of 9.5 (7.5-18) years of follow-up treated by the same surgeon were divided into 2 groups according to the age of deformity onset. Demographics and deformity characteristics of patients were defined, treatment times, bone healing indexes, consolidation/correction rates, problems encountered and results obtained were compared retrospectively. The results were compared with ASAMI functional and bone scoring. Complications were rated according to Paley and relative risk increases between groups were calculated.
26 of the patients were men and 22 were women. The average age was 26.47 (7-57). The mean deformity was 23.98° (7-60) and the mean shortness in 39 patients was 38.65 (10-110)mm. Mechanical axis deviation was corrected in 83% of patients. The Lengthening index was 54.13days/cm in the development group and 63.69 days/cm in adults. Consolidation/correction rate was 2.54 in developmental age and 2.4 (p=0.698) in adults. The risk increased by 1.02 times in terms of problems encountered, 2 for obstacles, 3 times in complications and 1.34 times in total difficulties per case, according to Paley. The duration of stay in the fixator was higher in developmental group (p=0.023). ASAMİ functional (p=0.000148) and anatomical (p=0.000242) scores were better in the adult group.
Congenital or acquired deformities in the lower extremity can be treated with satisfactory results by Ilizarov method. The development of deformity at an early age makes treatment difficult. Although the bone healing index is lower in this group of patients, which usually has a higher amount of shortness, the treatment is usually longer than that of adult deformities; complications are more frequent and serious. Functional and anatomical results are more unsuccessful.
采用伊里扎洛夫方法治疗下肢先天性或后天性畸形时并发症很常见。在特定患者群体中获得的结果各不相同。在本研究中,将16岁之前出现畸形的患者与16岁之后出现畸形的患者进行比较,无论病因类型如何,比较获得的结果、治疗持续时间和遇到的并发症。
由同一位外科医生治疗的53例骨畸形患者,平均随访9.5(7.5 - 18)年,根据畸形开始的年龄分为2组。定义患者的人口统计学和畸形特征,回顾性比较治疗时间、骨愈合指数、巩固/矫正率、遇到的问题和获得的结果。将结果与ASAMI功能和骨评分进行比较。根据Paley对并发症进行评级,并计算组间相对风险增加情况。
患者中26例为男性,22例为女性。平均年龄为26.47(7 - 57)岁。平均畸形为23.98°(7 - 60),39例患者的平均短缩为38.65(10 - 110)mm。83%的患者机械轴偏差得到矫正。发育组的延长指数为54.13天/cm,成人组为63.69天/cm。发育年龄组的巩固/矫正率为2.54,成人组为2.4(p = 0.698)。根据Paley的标准,遇到问题的风险增加1.02倍,障碍风险增加2倍,并发症风险增加3倍,每例总困难风险增加1.34倍。发育组固定器的留置时间更长(p = 0.023)。成人组的ASAMİ功能(p = 0.000148)和解剖学(p = 0.000242)评分更好。
下肢先天性或后天性畸形采用伊里扎洛夫方法治疗可获得满意结果。早期出现畸形会使治疗困难。虽然该组患者骨愈合指数较低,通常短缩程度较高,但治疗时间通常比成人畸形的治疗时间长;并发症更频繁且更严重。功能和解剖学结果更不理想。