针锯微创截骨矫形的临床应用

The clinical application of dowel saw technique in the osteotomy by orthopedic

目的总结应用针锯微创截骨矫正肢体畸形的临床经验。方法回顾性研究1980年2月至2008年8月应用针锯对1247例肢体畸形患者行截骨矫形手术的完整资料,男742例,女505例;年龄2～67岁,平均18岁。截骨部位:股骨髁上865例,胫骨近端358例,胫骨远端4例,第1掌骨基底部13例,肱骨上段1例,股骨中段1例,胫骨中段5例。截骨后行骨延长377例,截骨矫正肢体畸形870例。分析针锯的截骨原理和方法、手术后处理情况及术后并发症的防治。结果全部获得随访,随访时间12～26个月,平均16个月。截骨矫形区骨愈合时间6～8周,平均7周;截骨延长区骨愈合时间6～8个月,平均7个月;全部患者截骨处均获得骨性愈合。无一例患者发生神经、血管损伤及骨不愈合,截骨部位术后第2周出现骨生长现象,截骨延长,截骨处邻近关节功能恢复良好。结论应用针锯微创截骨矫形损伤小,安全可靠,无需开放手术,是一种较为理想的截骨矫形方法。

Objective To summary the clinical application of dowel saw technique in the treatment of limb deformity. Methods From February 1980 to August 2008, 1247 cases of deformity （742 male, 505 female） were repaired by losed fracture by dowel saw. There were totally 742cases of male and 505cases of female included, aged 2 -67 years old, average 18 years. To explain the principle and method of dowel saw osteotomy and complication. Results The average period of follow-up 16 months （range, 12 -26months）. All cases get bone union, There were no nerve or blood vessel injury, or non-union. In the second week after the operation, obviously ossification in the Osteotomy parts, and in 6 to 8 months （ mean 7 months） bone union was observed at the fractured site in all cases. The function of the manipulated vicinity joints recovered well. Conclusion dowel saw osteotomy is a mininally invasive and safe surgical approach and with no need of internal fixation and is an ideal way for alignment correction.