Simmons E D, Ginsburg G M, Hall J E
Children's Hospital of Boston, Harvard Medical School, Massachusetts, USA.
J Pediatr Orthop. 1996 Jan-Feb;16(1):85-9. doi: 10.1097/00004694-199601000-00017.
The results of reconstructive surgery in tibial hemimelia using a modified fibular transfer procedure as described by Brown were reviewed. A modified Brown's procedure was carried out on five patients with a total of seven affected limbs. A Syme's-type amputation of the foot was carried out in each case. All of the knees had quadriceps function preoperatively, which was considered a prerequisite for surgery. Average length of follow-up was 7 years, with a range of 2-12 years. The average age at time of surgery was 12.7 months, with a range of 7-26 months. At the time of review, all patients had reasonably good function of their lower extremities. All were ambulating with patellar tendon-bearing prostheses and thigh extensions for collateral support. The average arc of motion at review was 57.4 degrees, with further passive motion possible in all cases. Average extension was -18.5 degrees, and the average active flexion was 76 degrees. We found that a fibular centralization procedure in a patient with at least grade III+ quadriceps function can give good functional results that do not appear to deteriorate over time.
我们回顾了采用布朗所描述的改良腓骨转移术治疗胫骨半侧发育不全的重建手术结果。对5例患者共7条患肢实施了改良布朗手术。每例均行Syme氏型足部截肢术。所有患者术前膝关节均有股四头肌功能，这被认为是手术的前提条件。平均随访时间为7年，范围为2至12年。手术时的平均年龄为12.7个月，范围为7至26个月。在复查时，所有患者下肢功能均相当良好。所有患者均使用髌腱承重假肢和大腿伸展装置辅助行走以提供侧方支撑。复查时的平均活动弧度为57.4度，所有病例均可进一步被动活动。平均伸展度为-18.5度，平均主动屈曲度为76度。我们发现，对于至少具有III +级股四头肌功能的患者，腓骨中心化手术可取得良好的功能结果，且这些结果似乎不会随时间恶化。
