先天性胫骨假关节治疗方法的研讨(附带血管腓骨移植八例报告)

Treatment of Congenital Pseudoarthrosis of Tibia——A Report of 8 Cases

先天性胫骨假关节是一种少见的畸形,治疗较困难.自1709年Hatzoecher描述本病以来,虽然经历了各种各样的治疗方法,但治疗效果至今不能令人满意.我院於1978年开始采用了目前最流行的手术方法一游离腓骨带血管的骨移植术(1).但成功率也是有限的.

Eight children, 5 males and 3 females, aged between 2 to 13, with congenital pseud-oarthrosis of tibia 'were treated in our hospital. In 6 cases, pseudoarthrosis occured on the left and in 2 on the right. Vascular pedicle grafting of fibula was performed oa 6 cases, simple resection of a neurofibroma on one pat-ient, and the 8th received a conservative tre-atment. Follow-ups by 4 to 8 yrs., satisfactory results were found in all cases.This disease cannot be treated indiscrimi-nately by any one therapy. Conservative treatment should be chosen for infants who are still too young to be operated oa. Added PEMF therapy is recommended. Pedicle graft of fibula is suitable for older children while other treatments are considered improper. Am-putation should be handled more carefully.When pedicle graft of fibula is performed, postoperative complications and the sequela of the excision of the fibula should be avoided.