Yadav Surender Singh
Mirpur Institute of Medical Sciences' (MIMS), Mirpur Haryana, India.
Int Orthop. 2025 Sep;49(9):2021-2028. doi: 10.1007/s00264-025-06599-w. Epub 2025 Jul 15.
Although a severe limb deformity is rare, its management continues to be quite challenging. Various options have been described for correction. However, most of them are expensive, extensive and result in complications. Correction of severe deformities of the extremities has been suggested using the yester biological procedures with successful long term outcome.
During the last five decades, 50 patients of challenging limb deformities were surgically managed by yester procedures which included corrective osteotomy, arthrodesis and Girdlestone arthroplasty. Eleven patients had upper limb deformity and 39 had lower limb deformity. Sixteen patients had congenital anomaly and 34 acquired. Twelve patients were non-walkers with multiple joint involvement. No metallic implant had been used in any case. No patient had repeat surgery. The age of the patients ranged from five-27 years.
Depending on the procedure adopted in a particular patient, all patients were examined periodically and regularly. The treatment time in a patient with multiple deformities ranged from six-12 months. Out of the twelve non-walkers, eleven could ambulate after the management. Superficial infection was recorded in 27 patients. No deep infection was observed. A long follow-up of 35 years has been available.
A rare series of 50 patients with challenging deformities of the extremities has been reported. The patients had been managed with procedures like corrective osteotomy, arthrodesis and Girdlestone arthroplasty with acceptable outcome. After the management 11 out of 12 non-walkers could ambulate themselves. The described procedures are simple, biological, dependable, patient friendly and available at no cost.
尽管严重肢体畸形较为罕见,但其治疗仍颇具挑战性。已有多种矫正方法被描述。然而,其中大多数方法昂贵、创伤大且会引发并发症。有人建议采用既往的生物学方法矫正四肢严重畸形,长期效果良好。
在过去的五十年间,50例具有挑战性的肢体畸形患者接受了包括矫正截骨术、关节融合术和Girdlestone关节成形术等既往方法的手术治疗。11例患者为上肢畸形,39例为下肢畸形。16例患者为先天性畸形,34例为后天性畸形。12例患者为非行走者,累及多个关节。所有病例均未使用金属植入物。无患者接受再次手术。患者年龄在5至27岁之间。
根据特定患者所采用的手术方法,对所有患者进行定期检查。患有多种畸形的患者治疗时间为6至12个月。12例非行走者中,11例在治疗后能够行走。27例患者出现浅表感染。未观察到深部感染。目前已有长达35年的随访结果。
报告了一组罕见的50例具有挑战性的四肢畸形患者。这些患者采用矫正截骨术、关节融合术和Girdlestone关节成形术等方法进行治疗,效果良好。治疗后,12例非行走者中有11例能够自行行走。所描述的方法简单、生物学特性良好、可靠、对患者友好且无需费用。