应用Ilizarov外固定延长架治疗小儿下肢短缩畸形

Treatment of lower extremity inequality in children with Ilizarov external fixator

目的总结小儿肢体延长的临床经验，探讨肢体延长中出现的并发症及其对策。方法采用Ｉｌｉｚｒｏｖ外固定延长架对１４例小儿下肢短缩畸形进行１５侧肢体延长。其中股骨下端截骨延长３例，胫骨上端截骨延长９例（１０侧肢体），胫骨下端截骨延长２例。结果随访１～６年，平均２年３个月。延长幅度３．０～１０．０ｃｍ，平均６．５ｃｍ。延长率达原骨长度的１２．５％～４５．５％，平均２２．９％。骨愈合时间：股骨延长平均２８０天，胫骨延长平均２１５天。骨愈合指数平均４１．５。结论应用Ｉｌｉｚａｒｏｖ外固定延长架可以较大幅度延长肢体。

Objective To summarize the experience of limb lengthening for children and to study the complications and their management during limb lengthening Methods Lengthening procedure of the lower extremity for 14 patients (15 limb segments) with lower extremity inequality were performed with Ilizarov external fixator and distraction osteogenesis Limb lengthening by distal femoral osteotomy was done in 3 cases,proximal tibial osteotomy in 9 cases (10 limb segements) and distal tibial osteotomy in 2 cases Results The average follow up was 2 years and 3 months (range, 1￣6 years) The average length gained was 6 5 cm (range,3 0～10 0 cm) The average percentage of length gained to the original bone length was 22 9% (range,12 5%～45 5%) The average healing time of bone was 280 days for the femur and 215 days for the tibia The average healing index was 41 5 Conclusions Large scale lengthening of lower extremity can be achieved by using Ilizarov external fixator and distraction osteogenesis,and special attention should be paid to the prevention and treatment of complications during the lengthening.