骨延长术治疗儿童尺桡骨发育畸形的初步观察

Treatment of ulnar and radial malformations by bone lengthening surgery

目的介绍利用骨延长术治疗儿童尺桡骨发育畸形方法。方法2001年7月到2007年3月对10例尺桡骨发育畸形的患儿进行了治疗，其中尺骨骨软骨瘤7例，桡骨骨骺损伤2例，先天性桡骨发育不全1例。利用骨延长术对这些畸形进行治疗（4例使用单臂Orthofix外固定延长器，6例采用Ilizarov外固定延长器），将延长器置于发育异常的骨两端，并在中间将骨截断，术后第5天开始延长，每天延长1mm，分4次延长。达到预期长度后，继续带延长器功能锻炼，直到软骨痂钙化后去除支架。结果10例患儿平均延长3．02cm，平均带架时间为141．3d，除1例钢针感染外，无血管神经并发症，手术后患儿前臂外观畸形得到纠正。结论对于尺桡骨发育畸形的患儿通过骨延长术可以使畸形得到纠正，同时早期手术可以避免畸形的进一步发展。

Objective To introduce a method of correcting ulnar and radial deformities by bone lengthening surgery. Methods Between September 2001 and March 2007,10 patients included 7 with chondrosteoma,2 with radius epiphysis injury and 1 with congenital deformity of the radius,underwent forearm lengthening via gradual distraction using various types of external fixators in this department. The distraction devices applied were the external Ilizarov fixator in 6 cases and external Orthofix fixator in 4 cases. The lengthening, which began on the 5^th day after the operation, was performed at a rate of 1 millimeter 4 times a day. Dirigation was applied to facilitate functional rehabilitation after proper retraction. The fixators weren＇t removed until the new callus calcified completely. Results Average prolongation was 3.02 cm. There was no complication except l patient suffering from pin tract infection. Appearance of forearm was improved. Conclusions Bone lengthening surgery can correct ulnar and radial deformities, and should be performed as early as possible to prevent secondary malformation developing.