Coleman S S, Stevens P M
Clin Orthop Relat Res. 1978 Oct(136):92-104.
Tibial lengthening as a means of correcting certain discrepancies in lower limb length has become a well-accepted, though rarely indicated, procedure. Success depends upon knowledgable evaluation of all factors involved in the problem, upon adherence to the indications and prerequisites, and upon strict attention to all details of the operation. Nearly all cases of tibial lengthening are accompanied or followed by problems and/or complications. Problems such as delayed union, inadequate union and failure of union must be anticipated and appropriately coped with. Complications such as fracture through the lengthened area, compartment syndromes, infection, and foot and ankle deformities must be prevented if at all possible, and aggressively treated when they occur. Utilizing the appropriate indications and meticulous technique, one can expect to achieve lengthening of 4--5 cm in nearly all cases. Bone grafting and internal fixation will be required in a significant number of tibial lengthenings in order to achieve strong, solid union. The technique currently employed by the authors utilizes the Anderson percutaneous osteotomy, accompanied by the Wagner apparatus. In critically analyzing the results of 73 personal cases of tibial lengthening, the authors conclude that the procedure is justified in carefully selected patients.
胫骨延长术作为纠正下肢长度某些差异的一种方法，已成为一种虽很少应用但已被广泛接受的手术。手术成功取决于对该问题所涉及的所有因素进行明智的评估，取决于遵循适应证和前提条件，以及严格关注手术的所有细节。几乎所有胫骨延长病例都会伴有或随后出现问题和/或并发症。诸如骨愈合延迟、愈合不充分和骨不连等问题必须预先考虑并妥善处理。诸如延长部位骨折、骨筋膜室综合征、感染以及足踝畸形等并发症必须尽可能预防，一旦发生则积极治疗。采用适当的适应证和精细的技术，几乎所有病例都有望实现4至5厘米的延长。为了实现牢固的骨愈合，大量胫骨延长手术需要进行骨移植和内固定。作者目前采用的技术是安德森经皮截骨术，并辅以瓦格纳器械。在对73例个人胫骨延长病例的结果进行批判性分析后，作者得出结论，该手术在精心挑选的患者中是合理的。
