应用延长重建手术治疗下肢短缩畸形2 574例数据分析

Data Analysis of 2574 Cases with Lower Extremity Short Deformity Treated with Limb Lengthening Technique

目的回顾性分析35年中应用肢体延长术治疗的下肢短缩畸形及不等长患者数据,探讨肢体延长术应用对象的分布及变化情况。方法通过对矫形外科病例数据库进行资料提取,选取1983年1月至2017年12月接受下肢延长术治疗的2574例患者资料。其中男1556例(60.45%),女1018例(39.55%);年龄3~58岁,平均(21.91±10.18)岁。统计分析患者性别、年龄、术前步态、延长部位、侧别及原发疾病种类等情况。结果接受手术患者主要集中在11~30岁(2204例,85.63%);术前行走状态包括轻度跛行1402例(54.47%),重度跛行528例(20.51%)等9种情况;手术延长部位包括髂骨、胫腓骨、股骨、跟骨、跖骨、跗骨等6个部位,接受髂骨延长术明显出现随时间变化的趋势;原发疾病种类包括以脊髓灰质炎后遗症为主的超过54种疾病。结论患者数据分布规律反应出,接受肢体延长术治疗的患者群体中,医疗资源存在向男性倾斜的倾向,不同年龄段患者对治疗需求存在差异,患者改善功能的需求远超单纯改善外观需求,施术部位具有随时间出现变化的趋势,为了解下肢短缩畸形患者及肢体延长术的基本情况提供了经验与依据。

Objective To summarize the data of the patients accepted limb lengthening surgeries in past 35 years and to discuss the distribution and changes of the patients accepted limb lengthening treatment.Methods We retrospectively reviewed 2574 patients who accepted limb lengthening surgeries in Qin Sihe's orthopedic team between January 1983 and December 2017.The data of gender,age,gait,surgical area and pathogenesis were analyzed.Results 2574 patients were included in this group.Gender distribution was 1556 males(60.45%)and 1018 females(39.55%).The age ranged from 3 years to 58 years with an average of(21.91±10.18)years.9 walking situations were recorded pre-operation,including mild claudication 1402 cases(54.47%)and severe claudication 528 cases(20.51%).The lengthening sites including ilium,femur,tibia and fibula,calcaneum,metatarsus and tarsus.Over 54 etiologies including sequalae of poliomyelitis,trauma and et al.Conclusion Distribution of the patients revealed that,more male patients accepte limb lengthening compared with females.Patients in different life phase have different demands of treatment,more patients wish to improve their limb function compared with change the appearance and the surgical area varies over time.The data of the patients provide precious experiences for understanding the situation of the patients with limb discrepancy and the development of limb lengthening technique.