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伊里扎洛夫技术用于矫正儿童肢体畸形的并发症。

Complications of use of the Ilizarov technique in the correction of limb deformities in children.

作者信息

Velazquez R J, Bell D F, Armstrong P F, Babyn P, Tibshirani R

机构信息

Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Canada.

出版信息

J Bone Joint Surg Am. 1993 Aug;75(8):1148-56. doi: 10.2106/00004623-199308000-00004.

Abstract

We reviewed the records of the first forty patients who had been managed at our institution with the Ilizarov technique for the correction of limb deformities, including limb-length inequality, to delineate the complications of this method of treatment. The duration of follow-up ranged from two and one-half to four years. A complication was defined as any untoward occurrence to a patient either during the course of treatment or after removal of the fixator. A major complication was considered one that necessitated an additional operative procedure; caused lasting sequelae, such as malunion, deformation of new bone, joint contracture or stiffness, or nerve palsy; or prolonged the treatment. A minor complication was regarded as one that responded to non-operative treatment and did not cause lasting sequelae, such as transient decreased motion of the joint, paresthesia, or pin-track infection. There were eighty-eight complications--thirty-eight, major, and the remaining fifty, minor--in the sixty-one segments of the limb that were treated; this represented an average of almost one and one-half complications for each segment. Twenty-nine unplanned operative procedures were performed either during treatment with the Ilizarov technique or after removal of the fixator. As anticipated, the prevalence of major complications was highest in the patients who had had more complex and prolonged treatment. Such complications were encountered less often as the surgeons gained experience with the procedure, but the rate of minor complications remained relatively constant, despite the increased experience.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们回顾了我院首批40例采用伊里扎洛夫技术治疗肢体畸形(包括肢体长度不等)患者的记录,以明确该治疗方法的并发症。随访时间为两年半至四年。并发症定义为患者在治疗过程中或去除固定器后出现的任何不良情况。主要并发症是指需要额外进行手术的情况;导致持久后遗症,如骨不连、新骨变形、关节挛缩或僵硬、或神经麻痹;或延长治疗时间。次要并发症是指经非手术治疗后好转且未导致持久后遗症的情况,如关节活动度短暂下降、感觉异常或针道感染。在接受治疗的61个肢体节段中,共出现88例并发症,其中38例为主要并发症,其余50例为次要并发症;平均每个节段出现近1.5例并发症。在伊里扎洛夫技术治疗期间或去除固定器后,共进行了29次非计划内手术。正如预期的那样,在接受更复杂、更长时间治疗的患者中,主要并发症的发生率最高。随着外科医生对该手术的经验增加,此类并发症的发生率降低,但次要并发症的发生率保持相对稳定,尽管经验有所增加。(摘要截选于250字)

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