Synder M, Niedzielski K
Katedry i kliniki Ortopedii AM, Lodzi.
Chir Narzadow Ruchu Ortop Pol. 1997;62(5):431-6.
Lengthening is generally accepted method of treatment for extremity length discrepancy. This attractive method carries the risk of many complications that may ruin primary treatment plan. The aim of this paper was to analyze complications and their management in own material consisting of 60 extremities in 58 patients aged 8-37 years. Limb length discrepancy was caused by congenital bony hypoplasia in 44 cases, trauma in 8 and infection in 8 cases. Initial shortening ranged from 4 to 15 cm (mean 6.5 cm). Ilizarov technique was used in 20 cases, Wagner method in 6 cases and DeBastiani in 34 cases. Expected elongation has been achieved in 60% cases; in remaining 40% complications occurred. New bone formation disturbances and axial malalignement were among most severe ones. An autogenic marrow injections were used to stimulate callus formation, osteogenon was administered. Axial malalignement was corrected by osteotomy. Percentage of complications decreased as number of elongations performed increased.
肢体长度不等的治疗,延长术是普遍接受的方法。这种颇具吸引力的方法存在诸多并发症风险,可能会破坏初始治疗方案。本文旨在分析我院58例年龄在8至37岁患者60个肢体的并发症及其处理情况。肢体长度不等由先天性骨发育不全导致的有44例,创伤导致的有8例,感染导致的有8例。初始短缩范围为4至15厘米(平均6.5厘米)。采用伊里扎洛夫技术的有20例,瓦格纳方法的有6例,德巴斯蒂亚尼方法的有34例。60%的病例达到了预期延长效果;其余40%出现了并发症。新骨形成障碍和轴向排列不齐是最严重的并发症。采用自体骨髓注射刺激骨痂形成,应用成骨素。通过截骨矫正轴向排列不齐。随着延长次数的增加,并发症的发生率降低。