Ilizarov外固定架治疗尺骨骨干续连症的早期疗效分析

Ilizarov technique for the treatment of forearm deformities in hereditary multiple exostose

目的探讨应用Ilizarov外固定架治疗儿童尺骨骨干续连症的早期疗效。方法2014年2月至2017年2月,湖南省人民医院采用骨软骨瘤切除、Ilizarov外固定架延长尺骨术矫治17例尺骨骨干续连症患者,通过定期门诊复查及拍摄患肢X线片评估术后患肢畸形及功能改善情况。结果17例术后平均随访30个月,尺骨平均延长26.99 mm;1例延长过程中出现钉道感染,通过口服抗生素及加强钉道护理治愈;1例拆除外固定架后发生尺骨延长段骨折,石膏固定后自行愈合;1例在末次随访时出现尺骨再发短缩。术后患者RAA、US、CS及腕关节、肘关节、前臂功能均得到改善。结论应用骨软骨瘤切除、Ilizarov外固定架延长尺骨术治疗儿童尺骨骨干续连症早期效果满意。

Objective To explore the application of Ilizarov external fixation forearm deformities in hereditary multiple exostoses(HME).Methods From February 2014 to February 2017,17 children with forearm deformities in HME underwent corrective osteotomy plus gradual lengthening of ulna by Ilizarov external fixation,corrective osteotomy of radius and excision of exostoses.The surgical outcomes and functional improvements of forearm were assessed via regular follow-ups and radiography.Results During an average follow-up period of 30 months,the average lengthening of ulna was 26.99 mm.One case of pin-track infection was properly controlled by pin care and oral antibiotics.Fracture occurred in one child after frame removal and healed after 4-week casting.And ulnar shortening re-occurred in another child at the last follow-up.The radiographic parameters of relative ulnar shortening(US),radial articular angle(RAA)and carpal slip(CS)improved.The postoperative functions of wrist,elbow and forearm all improved.Conclusion The treatment of forearm deformities in HME using the Ilizarov technique is efficacious during an early stage.