半环式外固定架骨延长治疗儿童下肢短缩畸形

Treating Lower Limb Discrepancy of Children with Semicircular External Fixator and Gradual Bone Distraction Technique

目的 :介绍应用半环式外固定架渐进性骨牵伸 /加压技术治疗儿童下肢短缩的经验。方法 :单纯下肢短缩采用股骨远端或胫骨近端横行截骨 ,半环式外固定架牵伸延长 ;胫骨骨缺损、骨不连性肢体短缩除截骨延长外 ,还将假关节两骨端修整成相互嵌合的“V”形并加压。结果 :16例患儿骨延长 4～ 8cm ,平均 4.7cm ,均达预期长度。结论 :半环式外固定架骨延长治疗儿童下肢短缩畸形疗效满意 ,合并骨缺损、骨不连的肢体短缩是应用半环式外固定架骨延长的理想适应证。

Objective:To present the experience of treating lower limb discrepancy of children with semicircular external fixator and gradual bone distraction/compression technique. Method: For the cases of pure limb discrepancy, transverse osteotomies were performed in the distal femur or proximal tibia and semicircular external fixators were used for gradual bone distraction. For the cases with bone defect or nonunion, besides the bone osteotomy and the following distraction, the both bone ends of the pseudarthrosis were trimmed to the “V”shapes that corresponded to each other and were compressed. Result: The lengthening was from 4 to 8cm and 4.7cm in average in all 16 patients. All the limbs were lengthened to the expected length. Conclusion: Semicircular external fixator and its related bone distraction technique can be used to treat lower limb discrepancy of children with satisfactory result. Lower limb discrepancy with bone defect or nonunion is the optimal indication for the treatment of bone lengthening by using semicircular external fixator.