Stürz H, Hinterberger J, Matzen K, Plitz W
Arch Orthop Trauma Surg (1978). 1979 Oct;95(1-2):113-22. doi: 10.1007/BF00379178.
Fracture of the distraction rod is one of the complications following operative treatment of scoliosis by the device of Harrington. It is reported to occur in about 7% of cases. We found this complication twice in our own number of 41 patients during a follow up period of 1 to 4 years. The rods had broken 18 and 23 months after operation, but we never saw a breakage in the 1st postoperative year during the time of cast fixation. The fracture surfaces of each rod were examined under the scanning electron microscope. In one case a fatigue fracture with two beginnings at the opposite sides of the rod was found in combination with a forced fracture in the middle. The number of alterations of load from the beginning of the fracture to the complete breakage was about 10,000. The X-ray showed a loss of correction in the curve of 20 degrees with a pseudoarthrosis visible in the fusion. In the other case a typical pure fatigue fracture was seen 23 months after the operation with 18,000 alterations of load. The X-ray showed only a slight loss of correction of less than 5 degrees and no pseudoarthrosis was visable, neither in the X-ray nor in the operative exploration of the fusion. The breakage of the distraction rod results not only from a pseudoarthrosis but also from other explained facts of the procedure. Further treatment depends on a proven pseudoarthrosis.
撑开棒断裂是哈灵顿器械手术治疗脊柱侧弯后的并发症之一。据报道，其发生率约为7%。在我们随访的41例患者中，随访时间为1至4年，发现了2例这种并发症。撑开棒分别在术后18个月和23个月发生断裂，但在术后第一年石膏固定期间，我们从未见过断裂情况。对每根撑开棒的断裂面进行了扫描电子显微镜检查。其中1例发现是疲劳性骨折，棒的相对两侧有两个起始点，同时在中间有一处强力骨折。从骨折开始到完全断裂，负荷变化次数约为10000次。X线显示侧弯角度丢失20度，融合处可见假关节形成。另一例在术后23个月出现典型的单纯疲劳性骨折，负荷变化18000次。X线仅显示矫正丢失小于5度，无论是X线还是融合部位的手术探查均未发现假关节形成。撑开棒断裂不仅是由假关节引起的，还与手术过程中的其他已知因素有关。进一步的治疗取决于已证实的假关节形成情况。
