Guidera K J, Helal A A, Zuern K A
Department of Orthopaedic Surgery and Rehabilitation, University of South Florida College of Medicine, Tampa, USA.
Adv Pediatr. 1995;42:501-43.
The treatment of limb length inequality in pediatric patients is a complicated and long-term procedure, and careful evaluation is necessary over several visits. A team approach with an involved family is essential, as is knowledge and familiarity with the various conservative and surgical options. Treatment must not be rushed, and it is important to realize that not everyone needs a lengthening. Soft tissue and osseous complications are significant in these procedures, so shoe lifts and shortening procedures are attractive alternatives in smaller discrepancies. This condition is in a growing child and therefore not static. Future growth may dictate that procedures be staged. Most importantly, we must carefully equalize limb length in a manner that is neither physically nor emotionally scarring (Fig 26). These children are best served by a well-thought out plan that minimizes both kinds of trauma, decreases hospital and treatment time, and involves the family and patient in the planning and understanding of the proposed intervention and potential complications.
小儿患者肢体长度不等的治疗是一个复杂且长期的过程，需要多次就诊进行仔细评估。采用团队协作方式并让患儿家庭参与其中至关重要，同时了解并熟悉各种保守和手术治疗方案也很关键。治疗不能操之过急，而且必须认识到并非所有人都需要延长肢体。在这些治疗过程中，软组织和骨并发症较为严重，因此对于较小的肢体长度差异，鞋垫和缩短手术是有吸引力的替代方案。这种情况发生在生长发育中的儿童身上，因此并非一成不变。未来的生长情况可能决定治疗需分阶段进行。最重要的是，我们必须以一种不会造成身体或情感创伤的方式仔细平衡肢体长度（图26）。精心制定的计划最有利于这些患儿，该计划能将两种创伤降至最低，减少住院和治疗时间，并让家庭和患者参与到治疗方案及潜在并发症的规划和理解当中。
