Chen Shu, Gao Bin, Shi Qiang
Department of Pediatric Orthopedics, Guangzhou Huaxin Orthopedic Hospital, Guangzhou, 510507, China.
Department of Spine Surgery Zone 1, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, 410018, China.
J Orthop Surg Res. 2025 Aug 12;20(1):761. doi: 10.1186/s13018-025-06183-3.
Genu varum in children with hypophosphatemic rickets are complex and always occur on multiple planes, which are difficult to correct. This present study is aimed to retrospectively explore the feasibility and efficacy of 3D-printed model combined with the Ilizarov technique in the treatment of genu varum in children with hypophosphatemic rickets.
From March 2010 to July 2020, 7 hypophosphatemic rickets patients with genu varum were retrospectively analyzed in our hospital. Under the assistance of 3D-printed model, all of them were performed double-level osteotomies successfully with Ilizarov fixation. There were 3 boys and 4 girls. All patients had abnormal alignment of their lower limbs, with 14 limbs having genu varum deformity. The age of patients when they obtaining the corrective surgery averaged 7 years with a range of 5-10 years.
All patients were followed up for a period of 29-95 months, with an average of 44.5 months. Bony union was achieved for 5 to 10 months (average 6.9 months) after double-level osteotomies. During the last follow-up, no complaints of pain, no restriction of motion of the knee joints, or recurrence was found. The average preoperative mLDFA was 98.8 degrees (89-113 degrees), and the average mLDFA at the final follow-up was 93.4 degrees (85-101 degrees). Meanwhile, the MPTA improved significantly from 83.6 degrees (74-88 degrees) to 86.7 degrees (78-90 degrees), as well as the MAD from 65.7 mm medial (62-71 mm) to 18.5 mm medial (14-21 mm).
For genu varum in children with hypophosphatemic rickets, double-level osteotomies and Ilizarov fixation with the aid of 3D-printed model can achieve promising clinical and radiological outcomes with few complications.
低磷性佝偻病患儿的膝内翻情况复杂,且总是在多个平面出现,难以矫正。本研究旨在回顾性探讨3D打印模型联合伊利扎洛夫技术治疗低磷性佝偻病患儿膝内翻的可行性和疗效。
回顾性分析2010年3月至2020年7月在我院就诊的7例低磷性佝偻病膝内翻患儿。在3D打印模型的辅助下,所有患儿均成功进行了双平面截骨术并采用伊利扎洛夫固定。其中男孩3例,女孩4例。所有患儿均存在下肢力线异常,14条下肢有膝内翻畸形。接受矫正手术时患儿的平均年龄为7岁,范围为5至10岁。
所有患儿均随访29至95个月,平均44.5个月。双平面截骨术后5至10个月(平均6.9个月)实现骨愈合。在末次随访时,未发现疼痛主诉、膝关节活动受限或复发情况。术前平均外侧髌股角(mLDFA)为98.8°(89°至113°),末次随访时平均mLDFA为93.4°(85°至101°)。同时,机械轴胫骨角(MPTA)从83.6°(74°至88°)显著改善至86.7°(78°至90°),内侧胫骨关节面与机械轴的垂直距离(MAD)从内侧65.7 mm(62至71 mm)改善至内侧18.5 mm(14至21 mm)。
对于低磷性佝偻病患儿的膝内翻,借助3D打印模型进行双平面截骨术和伊利扎洛夫固定可取得良好的临床和影像学效果,且并发症较少。