髓内钉在矫治儿童成骨不全严重肢体畸形中的应用

[目的]探讨用髓内钉治疗儿童成骨不全严重肢体畸形中的矫形和防止再骨折的作用。[方法]2000年1月-2004年8月期间，共治疗8例，男3例，女5例。术中均将弯曲股骨或胫骨行多段截骨后髓内钉固定。其中2．0mm克氏针置入2例，Ender钉3例，Nancy弹性髓内钉3例。[结果]术后8例畸形改善明显，随访9个月．5a，平均2．4a，随访中肢体未再发骨折，未见髓内针合并感染、骨不连等并发症。1例术前轮椅患儿术后可扶拐行走；1例发生克氏针骨外部分断裂。[结论]多段截骨矫形后内置髓内钉治疗儿童成骨不全，对矫正肢体畸形、减少再次骨折机会，效果确实可靠。

Intramedullary nails for correction of deformity in the lower limbs in children with osteogenesis imperfecta

[Objective]To explore the application of the intramedullary nails for correction of deformity in the lower limbs and decrease the opportunity of refracture in children with osteogenesis imperfecta.[Method]From Jan.2000 to Aug.2004,8 patients(3 males and 5 females),with 13 femurs and 3 tibias totally,with deformity in lower limps were corrected by multi-osteotomy and fixed with intramedullary nails,2 for K-wires;3 for Ender nails;and 3 for flexible intramedullary nails.[Result]All deformities were perfectly corrected.All patients were available at final follow up,for 9 months to 60 months,mean 30 months.None of the complications occurred postoperatively,such as infection in the incision or pin tract,nonunion,and refracture.One patient can walk by a stick from wheel-chair help preoperatively and one K-wire was disrupted near the end.[Conclusion]Multi-osteotomy and fixed intramedullary nails,can correct the deformity in the lower limbs perfectly and decrease the opportunity of refracture in children with osteogenesis imperfecta,which has been proved to be a reliable method.