Dodgin D A, De Swart R J, Stefko R M, Wenger D R, Ko J Y
Department of Orthopedics, Children's Hospital, San Diego, CA 92123, USA.
J Pediatr Orthop. 1998 Jan-Feb;18(1):95-101.
Despite a tendency for rotational abnormalities of the lower leg in children to improve spontaneously over time, some fail to correct and require corrective derotation osteotomy. In this retrospective study, we report the technique and results of the distal transverse tibial and fibular derotation osteotomy with Kirschner-wire fixation performed in 63 limbs of children with cerebral palsy, clubfoot, idiopathic tibial torsion, and myelomeningocele, as well as other less common conditions. There were no significant infections, neurologic complications, delayed or nonunions, or compartment syndromes as a result of the osteotomy. There were three (4.8%) complications, including late fracture (one), cross-union (one), and distal physeal closure (one). We conclude that transverse, same-level, distal tibial and fibular osteotomy fixated with crossed Kirschner wires is a safe, efficient, and effective surgical approach to the treatment of children with tibial torsion in a variety of clinical conditions.
尽管儿童小腿旋转异常有随时间自发改善的趋势，但仍有一些无法自行纠正，需要进行矫正性旋转截骨术。在这项回顾性研究中，我们报告了对患有脑瘫、马蹄内翻足、特发性胫骨扭转和脊髓脊膜膨出以及其他较罕见病症的儿童的63条肢体进行的经皮克氏针固定的胫腓骨远端横向旋转截骨术的技术和结果。截骨术后未出现明显感染、神经并发症、延迟愈合或不愈合，也没有骨筋膜室综合征。共有3例（4.8%）并发症，包括晚期骨折（1例）、交叉愈合（1例）和远端骨骺闭合（1例）。我们得出结论，交叉克氏针固定的横向、同水平胫腓骨远端截骨术是治疗各种临床情况下胫骨扭转儿童的一种安全、高效且有效的手术方法。
