下肢髓内延长技术应用进展

RESEARCH PROGRESS IN LOWER LIMB LENGTHENING BY INTRAMEDULLARY NAIL

目的对下肢髓内延长技术的应用进展进行综述。方法查阅国内外有关下肢髓内延长技术的文献,对其进行总结分析。结果下肢髓内延长系统主要包括机械型、电力马达驱动型及磁力驱动型。与传统外固定延长技术相比,该技术在并发症发生率、术后肢体功能、骨愈合、患者舒适度、切口美观度及住院时间等方面,均具有明显优势。但亦存在器械故障导致延长失败、髓内感染、血管神经损伤、延长长度受限、价格昂贵等不足,并在髓腔狭窄、多段弯曲、骨髓炎、皮肤感染、骺板未闭等情况下应用受限。结论下肢髓内延长是肢体延长技术的一大改进,目前临床应用较少,但初步临床疗效良好,是肢体延长、骨重建及矫形外科的发展方向。

Objective To summarize the research progress in the lower limb lengthening by intramedullary nail. Methods The domestic and foreign related literature about the lower limb lengthening by intramedullary nail was reviewed, summarized, and analyzed. Results The intramedullary nail lengthening systems can be divided into 3 types： distraction by mechanical strength, by motorized electronic power, or by motorized magnetic force. The new technology has obvious advantages in complication incidence, limb function, bone healing rate, comfortable and cosmetic degree of the patients, and hospitalization days compared with the external fixation, but it also has the disadvantages including lengthening failure of system breakdown, intramedullary infection, in）uries of vessel and nerve, limited distraction length, and expensive price of the apparatus. And the method also has several contraindications： narrow medulla, multiple curves of medulla, osteomyelitis, skin infection, and unclosed epiphyseal plate. Conclusion The lower limb lengthening by intramedullary nail is a major improvement of Ilizarov technology. Although the method has been used in limited cases, the preliminary clinical results are excellent, and it can be regarded as a new trend of the limb lengthening, bone reconstruction, and deformity correction.