450例肢残儿童手术矫治的临床体会

Experience of treating 450 children with limb deformity

目的:探讨各种原因所致的肢残儿童手术矫治的方法。方法:回顾性分析2005年4月～2007年8月对450例肢残儿童分别实施骨性与肌性矫治手术的临床资料,并观察其手术效果。结果:450例患儿术后随访423例,随访率达94%。随访时间最短1年2个月,最长3年6个月,其中显效14.18%(60/423);有效82.74%(350/423);无效3.07%(13/423)。结论:对12岁以下患儿多采用软组织矫形术(肌性矫形);12岁以上患儿:(1)畸形较轻者以骨性手术为主;(2)畸形较重者采用骨性+肌性联合手术;(3)对合并有高位畸形的患儿可分期手术,先矫上,后矫下。

Objective： To discuss the operative techniques of correcting limb deformities in children resuited from all sorts of reasons. Methods： Clinical data of 450 children with limb deformity that underwent bony or soft tissue correction between April, 2004 and August, 2007 were retrospectively analyzed and the curative effects were observed. Results： All cases were kept follow-up for a duration ranging from one year and two months to 3 years and six months. 60 out of the 450 cases showed marked curative effects （13.3%）, 377 showed effects （83. 78） and 13 （2.89%） showed no effect. Conclusion： 1. For most children with limb deformity who are under 12 years old, soft tissue correction is recommended. 2. For those who are above 12 years old, it depends on specific circumstance. If the deformity is slight, we can chose bony correction as the major treatment. If the deformity is severe, wed better treat them with bony and soft-tissue correction in combination. If the patients also have deformity in high level, we can choose staging surgery to correct upper deformity first and then lower one