小儿骨骺阻滞发育与膝外翻的手术治疗
Operative Management of Pediatric Physeal Bar Development and Genu Valgum.
作者信息
Naseer Shahrukh, Zamzam Mazen, Zakko Philip, Saleh Ehab S
机构信息
Oakland University William Beaumont School of Medicine.
Department of Orthopedic Surgery Corewell Health William Beaumont University Hospital.
出版信息
Orthop Rev (Pavia). 2024 Aug 3;16:121975. doi: 10.52965/001c.121975. eCollection 2024.
BACKGROUND
Pediatric orthopedic conditions present unique challenges due to ongoing skeletal growth and development. Managing these cases requires addressing both structural anomalies and functional deficits.
CARE PRESENTATION
This case report discusses a 13-year-old male with recurrent left knee pain exacerbated by physical activity. The patient's history of a left knee infection at 1.5 years of age, possibly septic arthritis or osteomyelitis, underscores the long-term consequences of early pathology on skeletal growth and alignment. Imaging studies revealed a distal lateral femur physis bar and genu valgum, necessitating surgical intervention.
MANAGEMENT AND OUTCOMES
The surgery involved medial distal femur hemiepiphysiodesis and lateral distal femur bar excision to correct anatomical deformities and restore optimal limb alignment and function. Postoperative rehabilitation, including targeted exercises to improve quadriceps strength, was crucial for functional recovery and reducing the risk of complications such as medial patellofemoral pain.
CONCLUSION
This case highlights the importance of a multidisciplinary approach in managing complex pediatric orthopedic cases.
背景
由于骨骼持续生长和发育，小儿骨科疾病带来了独特的挑战。处理这些病例需要解决结构异常和功能缺陷问题。
病例介绍
本病例报告讨论了一名13岁男性，其左膝疼痛反复发作，体育活动会使其加重。患者在1.5岁时曾患左膝感染，可能是化脓性关节炎或骨髓炎，这凸显了早期病变对骨骼生长和对线的长期影响。影像学检查显示股骨远端外侧骺板骨桥和膝外翻，需要进行手术干预。
治疗与结果
手术包括股骨远端内侧半骨骺阻滞术和股骨远端外侧骨桥切除术，以纠正解剖畸形并恢复最佳肢体对线和功能。术后康复，包括针对性锻炼以增强股四头肌力量，对于功能恢复和降低诸如髌股内侧疼痛等并发症的风险至关重要。
结论
本病例强调了多学科方法在处理复杂小儿骨科病例中的重要性。
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