肢体短缩-再延长技术序贯治疗Gustio ⅢC型骨折临床效果观察

Clinical effect of limb shortening and relengthening technique in sequential treatment of Gustio ⅢC fracture

目的 探讨肢体短缩-再延长技术序贯治疗Gustio ⅢC型骨折的临床效果。方法 选取大连医科大学附属二院自2019年9月至2022年9月收治的7例小腿Gustio ⅢC型骨折患者为研究对象。所有患者均应用肢体短缩-再延长技术序贯治疗。术中探查下肢血管、神经,并依据软组织、血管、神经损伤情况决定肢体短缩长度。肢体成活后1.5~3.0个月,应用Ilizarov骨搬移技术行骨延长治疗,恢复患肢长度。记录所有患者的预后情况。末次随访时,依据Kofoed功能评定标准评价患者的恢复情况。结果 7例患者均保肢成功,且通过Ilizarov骨延长治疗,达到双下肢基本等长的目的。术后随访8~30个月,平均(14.5±1.5)个月。末次随访时,7例患者中,优3例,良2例,可2例,优良率为71.43%(5/7)。结论 肢体短缩-再延长序贯治疗Gustio ⅢC型骨折疗效满意,既提高了保肢成活率,又降低了保肢难度,达到双下肢基本等长的目的。

Objective To investigate the clinical effect of limb shortening and relengthening technique in sequential treatment of Gustio ⅢC fracture.Methods Seven patients with Gustio ⅢC fracture of calf admitted to the Second Affiliated Hospital of Dalian Medical University from September 2019 to September 2022 were selected as the research objects.All patients were treated sequentially with limb shortening and relengthening technique.The blood vessels and nerves of the lower extremities were explored during the operation, and the length of limb shortening was determined according to the injury of soft tissues, blood vessels and nerves.At 1.5 to 3.0 months after limb survival, Ilizarov bone transport technique was used for bone lengthening to restore limb length.The prognosis of all patients was recorded.At the last follow-up, the patients′ recovery was evaluated according to the Kofoed functional assessment criteria.Results Limb salvage was successful in all 7 patients, and both lower limbs were basically the same length by Ilizarov bone lengthening treatment.The average follow-up period was(14.5±1.5)months(range, 8-30 months).At last follow-up, among the 7 patients, 3 were excellent, 2 were good, and 2 were fair, with an excellent and good rate of 71.43%(5/7).Conclusion The sequential treatment of limb shortening and relengthening for Gustio ⅢC fracture has a satisfactory effect, which not only improves the survival rate of limb salvage, but also reduces the difficulty of limb salvage, and achieves the goal of basically equal length of both lower limbs.