Laidlaw A T, Loder R T, Hensinger R N
University of Michigan School of Medicine, Section of Orthopaedic Surgery, Ann Arbor, USA.
J Pediatr Orthop. 1998 Jan-Feb;18(1):4-8.
We reviewed four children with multiple, recurrent, pathologic fractures caused by bone disease, excluding osteogenesis imperfecta, and in whom multiple osteotomies with telescoping intramedullary stabilization had been performed. The diagnoses were myelomeningocele in two children and Rett syndrome and fibrous dysplasia in one child each. Five long bones were stabilized; four femora and one tibia. The average age at surgery was 6 years 6 months; the average number of fractures that had occurred in the involved bone before surgery was 3.0 per bone. At an average follow-up of 2 years 4 months, the average number of fractures that had occurred after surgery in the stabilized bones was 0.2 per bone. There were no infections, nonunions, or rod complications. We believe that in the carefully selected patient, multiple osteotomies with intramedullary telescoping rod stabilization can be quite successful in solving the problem of recurrent fractures in children with diseases other than osteogenesis imperfecta.
我们回顾了4例因骨病导致多处反复病理性骨折的儿童病例,不包括成骨不全,这些患儿均接受了多次截骨术及可伸缩髓内固定术。其中2例诊断为脊髓脊膜膨出,1例为雷特综合征,1例为骨纤维发育不良。共对5根长骨进行了固定,其中4根股骨,1根胫骨。手术时的平均年龄为6岁6个月;术前受累骨平均发生骨折的次数为每根骨3.0次。平均随访2年4个月时,固定骨术后平均每根骨发生骨折的次数为0.2次。未发生感染、骨不连或内固定棒相关并发症。我们认为,对于精心挑选的患者,多次截骨术及髓内可伸缩棒固定术在解决成骨不全以外的疾病患儿反复骨折问题方面可能相当成功。