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[1]呂秉舒,田亞敏,李東升,等.帶血管腓骨翻轉(zhuǎn)內(nèi)固定聯(lián)合脛骨微創(chuàng)截骨Ilizarov骨延長術(shù)治療先天性脛骨假關(guān)節(jié)[J].中醫(yī)正骨,2020,32(06):65-68.
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帶血管腓骨翻轉(zhuǎn)內(nèi)固定聯(lián)合脛骨微創(chuàng)截骨Ilizarov骨延長術(shù)治療先天性脛骨假關(guān)節(jié)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年06期
頁碼:
65-68
欄目:
臨床報(bào)道
出版日期:
2020-06-20

文章信息/Info

作者:
呂秉舒田亞敏李東升呂秉樂
(河南省洛陽正骨醫(yī)院河南省骨科醫(yī)院,河南洛陽471002)
關(guān)鍵詞:
下肢畸形先天性 脛骨假關(guān)節(jié) 截骨術(shù) 骨延長術(shù) 伊利扎羅夫技術(shù)
摘要:
目的:觀察帶血管腓骨翻轉(zhuǎn)內(nèi)固定聯(lián)合脛骨微創(chuàng)截骨Ilizarov骨延長術(shù)治療先天性脛骨假關(guān)節(jié)的臨床療效及安全性。方法:2010年1月至2017年12月,采用帶血管腓骨翻轉(zhuǎn)內(nèi)固定聯(lián)合脛骨微創(chuàng)截骨Ilizarov骨延長術(shù)治療先天性脛骨假關(guān)節(jié)患者21例,男9例、女12例; 年齡6~14歲,中位數(shù)11歲; 初次手術(shù)20例,經(jīng)4次手術(shù)后病情復(fù)發(fā)1例; 均有患肢成角短縮畸形。術(shù)后隨訪觀察患肢畸形矯正、長度恢復(fù)、功能恢復(fù)以及并發(fā)癥發(fā)生情況。結(jié)果:本組患者均獲隨訪,隨訪時(shí)間18~42個月,中位數(shù)32個月。脛骨骨延長2.10~13.20 cm,中位數(shù)8.00 cm。拆除外固定架時(shí)間18~36個月,中位數(shù)28個月。調(diào)整外固定架次數(shù)為4~12次,中位數(shù)8次。截骨處骨折均愈合。脛骨近端外翻角,術(shù)前12.62°±4.80°、末次隨訪3.33°±1.20°; 踝關(guān)節(jié)外翻角,術(shù)前15.48°±4.68°、末次隨訪4.57°±2.62°; 雙側(cè)脛骨長度差,術(shù)前(9.10±3.55)cm、末次隨訪(1.49±0.55)cm; 下肢功能評價(jià)量表評分,術(shù)前(48.20±4.33)分、末次隨訪(75.33±3.71)分。2例出現(xiàn)再骨折,給予二次手術(shù)后骨折愈合; 2例出現(xiàn)跟腱短縮、1例出現(xiàn)膝關(guān)節(jié)屈曲畸形,經(jīng)康復(fù)鍛煉后均好轉(zhuǎn); 1例出現(xiàn)脛骨前側(cè)切口脂肪液化開裂,經(jīng)多次換藥后切口愈合; 所有患者均未出現(xiàn)血管神經(jīng)損傷和骨髓炎。結(jié)論:采用帶血管腓骨翻轉(zhuǎn)內(nèi)固定聯(lián)合脛骨微創(chuàng)截骨Ilizarov骨延長術(shù)治療先天性脛骨假關(guān)節(jié),可矯正患肢畸形、恢復(fù)患肢長度、促進(jìn)患肢功能的恢復(fù),且并發(fā)癥較少,值得臨床推廣應(yīng)用。

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備注/Memo

備注/Memo:
(收稿日期:2020-02-24本文編輯:時(shí)紅磊)通訊作者:呂秉樂E-mail:[email protected]
更新日期/Last Update: 2020-10-10