“S”形截骨术用于肢体延长的疗效及并发症观察

目的：观察“S”形截骨术在肢体延长中的应用疗效及常见并发症。方法选择我院2011年1月至2014年12月收治的行肢体延长术患者79例作为研究对象，按随机数表法分为观察组(n=40)和对照组(n=39)。观察组采取“S”形截骨术，对照组采取横行截骨术，比较两组的治疗情况（延长长度、延长幅度、牵伸时间）、术后恢复情况（外固定时间、骨愈合时间、骨愈合指数）、并发症发生情况（轴线偏移、疤痕挛缩、延迟愈合、筋膜室综合征、关节僵硬、针道感染）。结果观察组患者的肢体延长长度与延长幅度分别为(7.8±1.3) cm、(21.8±3.3)%，对照组患者分别为(8.2±1.6) cm、(22.1±4.2)%，两组比较差异均无统计学意义(P>0.05)；观察组患者的牵拉时间为(111.4±20.1) d，明显短于对照组的(140.2±23.7) d，差异有统计学意义(P<0.05)；观察组患者的外固定时间、骨愈合时间及骨愈合指数分别为(158.3±30.4) d、(347.5±46.1) d、(46.6±5.1) d/cm，均低于对照组(179.1±38.8) d、(379.4±43.9) d、(59.8±20.1) d/cm，差异均有统计学意义(P<0.05)；观察组患者的并发症发生率为17.5%(7/40)，低于对照组的38.5%(15/39)，差异有统计学意义(P<0.05)。结论应用“S”形截骨术进行肢体延长在取得满意肢体延长幅度基础上还可缩短牵拉时间、加快骨愈合速度，骨愈合指数低、术后并发症少，具有较高的临床应用价值。

Curative effects and complications of S-shaped osteotomy in limb lengthening

Objective To investigate the curative effects and complications of S-shaped osteotomy applied in limb lengthening. Methods A total of 79 patients, who underwent limb lengthening in our hospital from January 2011 to December 2014, were selected and divided into observation group (n=40) and control group (n=39) by random num-ber table method. The observation group was treated by S-shaped osteotomy, while the control group was treated by transverse osteotomy. The treatment status (extended length, extended range, drafting time), postoperative recovery (time of external fixation, bone healing time, bone healing index) and incidence of complications (axis deviation, scar contrac-ture, delayed union, fascia compartment syndrome, joint stiffness, pin site infection) were compared between the two groups. Results There were no significant differences between observation group (7.8±1.3) cm and (21.8±3.3)%] and control group (8.2±1.6) cm, (22.1±4.2)%] in the extended length and range of limbs (P>0.05). The drafting time of the patients in observation group (111.4±20.1) d] was significantly shorter than that of the control group (140.2±23.7) d, P<0.05]. The external fixation time, bone healing time and bone healing index of the patients in observation group (158.3± 30.4) d, (347.5 ± 46.1) d, (46.6 ± 5.1) d/cm] were significantly lower than those of the control group (179.1 ± 38.8) d, (379.4 ± 43.9) d, (59.8 ± 20.1) d/cm] (P<0.05);The incidence rate of complications in the patients in observation group 17.5%, (7/40)] was significantly lower than that in the control group 38.5%, (15/39)] (P<0.05). Conclusion The ap-plication of S-shaped osteotomy in limb lengthening not only can achieve satisfying limb extended range, but also can shorten drafting time and accelerate bone healing. The bone healing index is low and postoperative complications are few. It is of relatively higher clinical application value.