837例创伤后遗下肢畸形患者特点分析(秦泗河矫形外科数据库1978年5月25日——2020年12月31日)

Analysis on the characteristics of 837 patients with post-traumatic lower limb deformities from QIN Sihe Orthopaedic Surgery Database between May 25, 1978 and December 31, 2020

目的 基于秦泗河矫形外科数据库中创伤后遗下肢畸形患者临床资料,总结分析该类患者特点及治疗策略。方法 回顾性分析秦泗河矫形外科数据库中1978年5月25日—2020年12月31日期间,接受矫形手术治疗的837例创伤后遗下肢畸形患者临床资料。对患者性别、手术时年龄、来源地区、创伤侧别、矫形手术相关信息(手术时间、部位、类型以及术后固定方式)进行归纳分析。结果 837例患者来自全国32个省、直辖市、自治区及台湾地区。其中,男551例(65.83%)、女286例(34.17%);手术时年龄3~84岁,平均27.6岁,其中16~45岁年龄段患者最多(559例,66.78%);创伤以交通事故伤为主(639例,76.34%)。畸形主要累及单侧肢体,其中左侧394例(47.07%)、右侧376例(44.92%)。2008年—2017年手术患者最多,占53.05%(444/837)。患者均实施1个或多个部位手术(1 048个部位),其中踝关节及足趾手术矫正最多,占48.38%(507/1 048)。实施包括肌腱延长及软组织挛缩松解术等各类矫形手术1 204例次。术后联合骨外固定624例(Ilizarov外固定467例、组合式外固定157例),联合石膏或支具外固定213例。结论 创伤后遗下肢畸形患者中男性比重大,地域分布广,涉及下肢各个部位且以足踝部多见,矫形手术联合骨外固定(Ilizarov技术)是畸形矫正和功能重建的主要方式。

Objective To summarize and analyze the characteristics and treatment strategies of post-traumatic lower limb deformity based on QIN Sihe Orthopaedic Surgery Database. Methods A clinical data of 837 patients with post-traumatic lower limb deformities treated by orthopaedic surgery between May 25, 1978 and December 31, 2020 in QIN Sihe Orthopaedic Surgery Database were analyzed retrospectively. The information of the patient’s gender, age at the time of surgery, region of origin, cause of trauma, deformity side, orthopedic surgery related information(operation time, location, type, and fixation method after operation) were summarized and analyzed. Results All patients came from 32 provinces, municipalities, autonomous regions, and Taiwan in China. Among them, 551 cases(65.83%) were male and 286 cases(34.17%) were female. The age of the patients at the time of surgery was 3-84 years old,with an average of 27.6 years old, and the most patients were 16-45 years old(559 cases, 66.78%). The main cause of trauma was traffic accident injury(639 cases, 76.34%). The deformity mainly involved unilateral limbs, including 394 cases(47.07%) on the left side and 376 cases(44.92%) on the right side. The most patients were admitted between 2008 and2017, accounting for 53.05%(444/837). All patients were operated on one or more sites(1 048 sites), among which ankle and toe surgery were the most, accounting for 48.38%(507/1 048). The patients received 1 204 surgeries including tendon lengthening and soft tissue contracture release, et al. Orthopedic surgery combined with bone external fixation was used in624 cases(467 cases of Ilizarov external fixation and 157 cases of combined external fixation), and plaster or brace external fixation was used in 213 cases. Conclusion Post-traumatic lower extremity deformity patients have a large proportion of males, with a wide geographical distribution, involving various parts of the lower extremities, and most commonly in the foot and ankle. Orthopedic surgery combined with bone external fixation(Ilizarov technique) is the main methods for correction and functional reconstruction of post-traumatic lower limb deformity.