股骨下端“L”形截骨一次性和逐渐性相结合延长治疗股骨短缩畸形

“L” osteotomy of distal femur with once and gradually lengthening of femur for femoral shortening

目的 解决一次性延长因血管、神经等并发症难以达到延长目的，而逐渐性延长治疗时间持续太长等问题。方法 在股骨下干骺端行“Ｌ”形截骨，术中延长２ ～３ ｃｍ ，剩余部分术后继续逐渐延长。结果 １８ 例延长的长度为３－０ ～８－５ ｃｍ（平均６－４ｃｍ） 。步态正常者９ 例，膝关节活动正常８ 例。平均住院日为３４－５ 天，远低于逐渐性延长组５６－７ 天。结论 一次性和逐渐性相结合延长的方法并发症少、治疗疗程明显缩短，是较理想的截骨延长方法。

Objective Because of problem of the blood vessel and nerve, once lengthening is difficult to achieve the aim of limb lengthening. Morever hosiptalization time of the gradually lengthening is too long. The technique was developed for overcoming the problem. Methods An improved method of “L” osteotomy once and gradually lengthening was developed. 2～3 cm lengthening was produced in operation immediately and surplus lengthening kept making after operation. Results 18 patients obtained satisfactory results, 9 patients demonstrated correct steps and 8 patients showed normal knee joint activity. The lengthening was 3 0～8 5 cm (average 6 4 cm). The average hospitalization time was only 34 5 days, far fewer than group of gradually lengthening(56 7 days). Conclusion Once lengthening combined with gradually lengthening is beneficial to patients because of fewer complications and short treatment course.