应用Ilizarov技术进行肢体延长

Limb lengthening with Ilizarov technique

目的应用Ilizarov技术进行肢体延长,探讨其对骨愈合过程中的影响。方法1991/1999年应用Ilizarov技术治疗肢体不等长39例,男22例,女17例,年龄8～15岁,平均12.5岁。肢体短缩3～12cm,平均6cm,均采用改良干骺端皮质骨截骨术,术后7d开始延长,1mm/d,分2～4次完成。延长1周后拍X线片,了解截骨是否完全、截骨对位对线情况,如有轴向偏移等,随时调整。以后每3周拍X线片1次,了解延长情况,新骨形成情况,达到预期延长长度后停止延长,带外固定架至延长区获骨性愈合后去除外固定架。结果所有病例均达预期延长长度,延长2.0～14.5cm,平均7cm,胫骨延长3～12cm,股骨4～10cm,胫骨、股骨同时延长11.0～14.5cm,尺骨2.0～3.5cm,愈合指数25～43d/cm,平均31d/cm。结论Ilizarov延长技术合理,手术切口小,创伤小,骨膜剥离少,对局部血供破坏小,明显缩短了截骨愈合时间。

Aim To explore the effect of Ilizarov tec hnique used for li mb lengthening on bone healing.Methods From 1991to 1999,39patients w ith limb length inequality were tre ated with Ilizarov technique.There were22 males and 17females,with an avera ge age of 12.5years(aged from 8to15 years).The length of limb shortened 3to 12c m(mean 6cm).Limb lengtheni ng(1mm /d,2to 4times /d)were started at 7days after patients received t he operation of modified c ortical bone osteotomy of metaphysis.After 1week,X -ray was used once thre e weeks to master the condition of limb lengthening.Ac hieving the exp ectation,limb lengthening was stop ped and external fixation wa s removed.Results As expected,limbs of 39cases all lengthened 2.0-14. 5cm(mean 7cm).The length of tibia lengthed3-12cm,that of femur lengthe ned 4-10cm,that of tibia and femur lengthened 11.0-14.5cm simulta neously,and that of ulnar lengthened2.0-3.5cm.The healing index was 2 5-43d /cm with an average value of 31d /cm.Conclusion Ilizarov techniqu e is reasonable,w ith the mini-mal skin incision and small area of periosteum detachment causing mild trauma and preserving the local blood supply.As a resul t,the duration of bone healing is shortened.