Wilkinson J M, Scott B W, Clarke A M, Bell M J
Sheffield Children's Hospital, England.
J Bone Joint Surg Br. 1998 Nov;80(6):999-1004. doi: 10.1302/0301-620x.80b6.8667.
The Sheffield Expanding Intramedullary Rod System was developed after experiencing problems with existing rod systems in the management of osteogenesis imperfecta. Between 1986 and 1996 we treated 74 bones in the lower limb in 28 children at a median follow-up of 5.25 years. We have reviewed 24 children with a total of 60 rods. Before surgery, all children had had multiple fractures of the lower limb. At review eight patients had experienced no further fractures, but three had suffered five or more subsequently. Before initial stabilisation, 15 children had never walked, and only three (13%) used walking as their main means of mobility. After surgery, half of those who showed motor arrest were able to walk (p = 0.016). The number of patients able to walk, with or without aids, increased to 17 (p = 0.0001). We have experienced no evidence of epiphyseal damage after the procedure, and complication rates requiring rod exchange have been low (7%).
谢菲尔德可扩展髓内棒系统是在处理成骨不全时，因现有棒系统出现问题后研发的。1986年至1996年间，我们对28名儿童的74根下肢骨骼进行了治疗，中位随访时间为5.25年。我们对24名儿童共60根棒进行了评估。手术前，所有儿童均有下肢多发性骨折。评估时，8名患者未再发生骨折，但3名患者随后发生了5次或更多次骨折。在初次稳定之前，15名儿童从未行走，只有3名（13%）以行走作为主要移动方式。手术后，半数出现运动停滞的患者能够行走（p = 0.016）。能够行走的患者数量，无论是否借助辅助器具，增加到了17名（p = 0.0001）。我们未发现该手术后有骨骺损伤的证据，需要更换棒的并发症发生率较低（7%）。
