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骺板阻滞术和半骺板阻滞术的引导生长技术:安全性与性能评估

Guided Growth Technique for Epiphysiodesis and Hemiepiphysiodesis: Safety and Performance Evaluation.

作者信息

Di Gennaro Giovanni Luigi, Trisolino Giovanni, Stallone Stefano, Ramella Marco, Rocca Gino, Gallone Giovanni

机构信息

Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.

Unit of Orthopedics and Traumatology, Ospedale Maggiore "Pizzardi", 40133 Bologna, Italy.

出版信息

Children (Basel). 2023 Dec 29;11(1):49. doi: 10.3390/children11010049.

Abstract

BACKGROUND

Guided-growth modulation is a first-line treatment widely adopted to correct lower-limb angular deformities and limb-length discrepancies (LLD) in the paediatric population.

METHODS

We conducted a retrospective study to evaluate the safety and performance of a new construct (8-Plate Plus or Guided-Growth Plate System Plus, Orthofix S.r.l) used to correct angular deformities and LLD in non-skeletally mature children. The primary endpoint was safety (from plate implantation to removal). The secondary endpoint was performance; patients treated for LLD achieved complete correction if a pre- and post-surgery difference of <0 was observed; angular deformities performance was measured in terms of IMD, ICD, mMPTA, and mLDFA.

RESULTS

We performed 69 procedures in 41 patients. A total of 10 patients had an LLD, and 31 had an angular deformity. We observed nine minor complications in the hemiepiphysiodesis group. One patient experienced rebound. All 10 LLD patient treatments were successful. A total of 30/31 patients with an angular deformity had a successful treatment; the remaining patient had a partial correction.

CONCLUSIONS

Guided-growth by temporary epiphysiodesis or hemiepiphysiodesis was safe and effective for angular deformities and limb-length discrepancies. Further prospective and/or randomized controlled trial studies assessing more significant cohorts of patients and a comparison group could add evidence to our findings.

摘要

背景

引导生长调节是一种广泛采用的一线治疗方法,用于矫正儿科人群的下肢角畸形和肢体长度差异(LLD)。

方法

我们进行了一项回顾性研究,以评估一种用于矫正非骨骼成熟儿童角畸形和LLD的新型装置(8孔钢板加强型或引导生长钢板系统加强型,奥索公司)的安全性和性能。主要终点是安全性(从钢板植入到取出)。次要终点是性能;如果观察到手术前后差异<0,则治疗LLD的患者实现完全矫正;角畸形性能通过IMD、ICD、mMPTA和mLDFA进行测量。

结果

我们对41例患者进行了69次手术。共有10例患者存在LLD,31例存在角畸形。我们在半骨骺阻滞组中观察到9例轻微并发症。1例患者出现反弹。所有10例LLD患者的治疗均成功。共有30/31例角畸形患者治疗成功;其余患者部分矫正。

结论

通过临时骨骺阻滞或半骨骺阻滞进行引导生长对于角畸形和肢体长度差异是安全有效的。进一步的前瞻性和/或随机对照试验研究,评估更多有意义的患者队列和对照组,可为我们的研究结果提供更多证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee2/10814807/317273f75a95/children-11-00049-g001.jpg

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