逆行髓内钉辅助在儿童股骨延长中的应用

目的:采用髓内钉辅助延长技术进行儿童股骨大段延长，评估其可行性，并对比同期矫正和分期手术的技术要点，明确此技术在儿童患儿中的应用价值。方法:自2014年7月7日至2018年1月16日共规划完成逆行髓内钉辅助延长手术10例，其中男9例，女1例；年龄（13.10±2.18）岁。所有患儿延长截骨点均位于股骨远端干骺端，初诊至...

Lengthening over retrograde nail technique of the femurs in children

Objective In this study,the feasibility of this method was evaluated in children with large distance femoral lengthening cases,and the acute correction and staging surgeries were compared at healing speed.At the same time the key points of surgical techniques would be summarized,so as to clarify the application value of this technology in children patients.Methods Since July 7 of 2014 to January 16 of 2018,a total of 10 cases of Lengthening Over Retrograde Nail(LORN)surgery have been formulated and carried out,including 9 males and 1 females.The average age of the operation was 13.10±2.18 y.In all cases,the osteotomy point was located in the metaphysis of the distal femur,and the records from the first meeting to the end of follow-up included gender,date of birth,reason of discrepancy and treatment history,age at surgery,lengthing distance,the length of duration with frame,healing time,ROM of the knee joint,complications,et al.To compare the healing time of acute correction and staging surgery.Statistical analysis was made by SPSS 22.0 software,and then reasonable treatment strategies were proposed.Results The average lengthing distance of 7.07±1.01 cm.The median time of the duration with frame was 8.5(4,16)months,and the median follow-up time was 39(34,54)months.All cases obtained good clinical and imaging healing(1.70±1.10 month/cm vs.1.16±0.54 month/cm),and all regained to normal walking function(136.67°±20.82°vs.125.71°±26.37°),without the occurrence of fracture after therapy.There were no statistically significant differences in the speed of healing,range of joint motion or complication rate between acute correction and staging treatment.Conclusion It is feasible for femoral lengthening surgery assisted by retrograde intramedullary nail in the treatment of femoral shortening deformityin children.The correction of mild angular deformity and lengthening surgery can be performed simultaneously.The osteotomy site was proposed at distal metaphysealof the femur for better quality of osteogenesis and shorter duration for fixator.It is safe to osteotomy and lengthening in the area of enchondroma.