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使用六足外固定器对一名软骨发育不全患者进行双侧肱骨延长及畸形矫正:病例报告

Bilateral humeral lengthening and deformity correction with hexapod external fixator in an achondroplastic patient: A case report.

作者信息

García López José María, García de la Blanca Juan Carlos, Martí Ciruelos Rafael, Núñez Ligero Guillermo

机构信息

Service of Traumatology and Orthopaedics Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain.

Service of Traumatology and Orthopaedics Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain.

出版信息

Int J Surg Case Rep. 2024 Oct;123:110285. doi: 10.1016/j.ijscr.2024.110285. Epub 2024 Sep 15.

DOI:10.1016/j.ijscr.2024.110285
PMID:39307029
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11440309/
Abstract

INTRODUCTION AND IMPORTANCE

Achondroplasia, a prevalent skeletal dysplasia, often results in limb asymmetry and functional limitations, typically managed surgically with bone lengthening techniques.

CASE PRESENTATION

We present the case of a 10-year-old girl with achondroplasia who underwent bilateral humeral lengthening using hexapod external fixators. The patient, previously treated for lower limb lengthening, exhibited significant upper limb shortening affecting daily activities. Surgical intervention involved two stages, employing two hexapod external fixators for precise correction and lengthening. Symmetrical lengthening of 6 cm in both humeri was achieved without major complications. Follow-up assessments revealed improved functionality and satisfactory outcomes, emphasizing the importance of addressing upper limb deformities in achondroplasia patients.

CLINICAL DISCUSSION

While humeral lengthening is less common than lower extremity lengthening due to historical concerns about neurovascular complications and functional implications, recent advancements highlight its potential benefits, particularly in achieving functional and aesthetic balance.

CONCLUSION

This case highlights the efficacy and safety of hexapod fixators in achieving multiplanar correction and functional improvement in upper limb lengthening. Further investigation should be carried out to study broader application in similar cases.

摘要

引言与重要性

软骨发育不全是一种常见的骨骼发育不良,常导致肢体不对称和功能受限,通常采用骨延长技术进行手术治疗。

病例介绍

我们报告了一例10岁软骨发育不全女孩的病例,她使用六足外固定器进行了双侧肱骨延长术。该患者此前接受过下肢延长治疗,上肢明显缩短,影响日常活动。手术干预分两个阶段进行,使用两个六足外固定器进行精确矫正和延长。双侧肱骨均实现了6厘米的对称延长,无重大并发症。随访评估显示功能改善,结果令人满意,强调了治疗软骨发育不全患者上肢畸形的重要性。

临床讨论

由于过去对神经血管并发症和功能影响的担忧,肱骨延长术不如下肢延长术常见,但最近的进展凸显了其潜在益处,特别是在实现功能和美学平衡方面。

结论

本病例突出了六足固定器在实现上肢延长的多平面矫正和功能改善方面的有效性和安全性。应进行进一步研究,以探讨其在类似病例中的更广泛应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/6d64f67bb9ab/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/f7219163f8b4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/da8834f05ac1/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/35355eb6f761/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/6d64f67bb9ab/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/f7219163f8b4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/da8834f05ac1/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/35355eb6f761/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/11440309/6d64f67bb9ab/gr4.jpg

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