Ilizarov技术联合髓内钉固定治疗先天性胫骨假关节

Ilizarov technique combined with intramedullary nail fixation in the treatment of the congenital pseudarthrosis of the tibia

目的探讨Ilizarov技术联合髓内钉固定治疗先天性胫骨假关节的疗效。方法采用Ilizarov技术联合髓内钉固定治疗10例先天性胫骨假关节患者。比较手术前后双下肢长度差、AOFAS踝-后足评分,记录术后并发症。结果患者均获得随访,时间9~40个月。术后发生胫骨力线异常3例,针道感染1例。8例患者胫骨假关节一期骨愈合,其中1例一期骨愈合后发生再骨折;2例未一期骨愈合。双下肢长度差末次随访较术前显著性减小(P<0.05)。AOFAS踝-后足评分末次随访与术前比较差异无统计学意义(P>0.05)。结论Ilizarov技术联合髓内钉固定治疗先天性胫骨假关节能有效促进胫骨假关节骨愈合,纠正双下肢不等长,保留患肢踝关节屈伸功能。

Objective To investigate the effect of Ilizarov technique combined with intramedullary nail fixation foRtreatment of the congenital pseudarthrosis of the tibia(CPT).Methods The 10 CPT patients were treated with Ilizarov technique combined with intramedullary nail fixation.The differences of loweRlimbs length,AOFAS ankle-hindfoot score were compared before and afteRoperation,and the postoperative complications were recorded.Results All patients were followed up foR9~40 months.There were 3 cases of abnormal tibial alignment,1 case of nail track infection.Primary tibial pseudarthrosis union occurred in 8 patients,including 1 case of refracture afteRprimary healing;2 cases did not heal in the one-stage.At the last follow-up,the length difference of both loweRlimbs was decreased significantly afteRoperation,compared with the preoperation(P<0.05).There was no significant change in AOFAS ankle-hinfoot score,compared with the preoperation(P>0.05).Conclusions In the treatment of CPT,the combination of Ilizarov technique and intramedullary nail fixation can effectively promote the bone healing of the CPT,correct the unequal length of both loweRlimbs,and preserve the flexion-extension function of ankle joint of the affected limb.