Haarmeyer A
Z Orthop Ihre Grenzgeb. 1978;116(6):802-9.
We report of three children suffering from Larsen-syndrome with the typical deformity of the face and multiple, mostly bilateral joint-luxations with severe affection of the hip-joints and knee-joints. Two patients had short terminal phalanxes with the typically spatulate terminal phalanxes of the thumb, radiographically visible. One child showed bilaterally dysplastic metacarpophalangeal bones with luxated metaphalanxes. The diagnosis could furtheron be verified by the characteristically twin-formed bone-nucleus of the calcaneus within all patients. Two children early showed a severe, progrediently developing scoliosis of the thoracal spine. The genetic aetiology of this syndrome, caused by a congenital weakness of the connective tissue, is not yet cleared completely. Especially the severe knee-joint luxations are therapeutically a critical problem. The multiple operative interventions which are necessary in the regions of the knee-joint, do not always lead to the expected success of treatment on account of the considerable weakness of the connective tissue. Therefore, additionally orthopaedic remedies are necessary. The already early progrediently developing scoliosis of the spine requires careful treatments with Milwaukee brace. A spondylodesis should be performed in the age from 6 to 8 years on account of the progredience. In any case, it is necessary to investigate carefully for accompanying malformations of the urinary passage.
我们报告了三名患有拉森综合征的儿童,他们有典型的面部畸形以及多处关节脱位,大多为双侧性,髋关节和膝关节受严重影响。两名患者的指骨末端短小,拇指末端呈典型的铲状,X线可见。一名儿童双侧掌指骨发育不良,掌骨脱位。所有患者跟骨特征性的双叶状骨核可进一步证实诊断。两名儿童早期出现严重的、进行性发展的胸椎侧弯。该综合征的遗传病因是结缔组织先天性薄弱,尚未完全明确。尤其是严重的膝关节脱位在治疗上是个关键问题。由于结缔组织相当薄弱,膝关节区域所需的多次手术干预并不总是能带来预期的治疗效果。因此,还需要骨科治疗手段。脊柱早期出现的进行性发展的侧弯需要用密尔沃基支具仔细治疗。鉴于病情进展,应在6至8岁时进行脊柱融合术。无论如何,必须仔细检查是否伴有尿路畸形。