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佝偻病下肢成角畸形矫正手术效果的横断面研究。

Surgical outcome of angular deformity correction of lower limbs in rickets: a cross-sectional study.

机构信息

Department of Orthopaedic and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia, Cheras, Malaysia.

出版信息

Eur J Orthop Surg Traumatol. 2024 Jul;34(5):2407-2412. doi: 10.1007/s00590-024-03943-5. Epub 2024 Apr 15.

Abstract

PURPOSE

This study aims to compare the functional and radiological outcomes following both guided growth surgery (GGS) and acute corrective osteotomy (ACO) correction of angular deformities in children with rickets.

METHODS

A total of 8 and 7 children who had gradual GGS and ACO correction, respectively, for angular deformities due to rickets from 2002 to 2022 were recalled for follow-up. Demographic data, types of rickets, data on pharmacological treatment, biochemical parameters, recurrence of angular deformity and postoperative complications were obtained from the medical records. A radiographic evaluation of the leg was performed to determine the tibiofemoral angle. For functional evaluation, the Active Scale for Kids (ASK) and Lower Extremity Functional Scale (LEFS) instruments were used for children below and above 15 years old, respectively.

RESULTS

In terms of the tibiofemoral angle, the GGS group documented greater angle changes compared to the ACO group, but the difference was not significant. In terms of functional outcomes, the overall score percentage of both groups was comparable with the GGS group showing a trend of higher score percentage compared to the ACO group. The GGS group presented no complication while 2 neurovascular injuries and 1 implant failure were recorded in the ACO group.

CONCLUSION

Both GGS and ACO procedures resulted in similar radiographic and functional outcomes for the treatment of rickets in children. GGS may be advantageous in terms of reducing complications of surgery. Nevertheless, the choice of surgical intervention should be made based on the patient's circumstances and the surgeon's preference.

摘要

目的

本研究旨在比较儿童佝偻病所致角度畸形行引导生长手术(GGS)和急性矫正截骨术(ACO)矫正后的功能和影像学结果。

方法

回顾性分析 2002 年至 2022 年间因佝偻病行逐渐 GGS 和 ACO 矫正角度畸形的 8 例和 7 例儿童的临床资料。从病历中获取人口统计学数据、佝偻病类型、药物治疗数据、生化参数、角度畸形复发和术后并发症的资料。对下肢进行影像学评估以确定胫股角。功能评估采用儿童适用的主动量表(ASK)和青少年以上适用的下肢功能量表(LEFS)。

结果

在胫股角方面,GGS 组的角度变化大于 ACO 组,但差异无统计学意义。在功能结果方面,两组的总体评分百分比相当,GGS 组的评分百分比呈上升趋势,高于 ACO 组。GGS 组无并发症,ACO 组发生 2 例神经血管损伤和 1 例植入物失败。

结论

GGS 和 ACO 手术治疗儿童佝偻病的影像学和功能结果相似。GGS 可能在减少手术并发症方面具有优势。然而,手术干预的选择应根据患者情况和外科医生的偏好来决定。

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