Ilizarov外固定器治疗小儿先天性胫骨假关节的临床研究

目的：观察Ilizarov外固定器的加压和稳定功能及其他有关因素对小儿先天性胫骨假关节的疗效。方法：用Ilizarov外固定器加压治疗5例先天性胫骨假关系，同时局部行病变切除，植骨髓内针控制角度以及用足部配件以稳定踝关节。结果：经0．6－5年随访，4例患儿假关节愈合，已拆除外固定器，在支具的保护下负重，1例患儿2次采用本法治疗后愈合。结论：小儿先天性胫骨假关节的治疗在于强调切除局部病变组织的重要性。同时，行胫骨近端骨延长术可能影响远端假关节的愈合。早日手术更为有益。

Clinical study on application of Ilizarov' s external fixator for the treatment of congenital pseudarthrosis of the tibia in children

Objective To observe the effect of Ilizarov technique combined with operation on congenital pseudarthrosis of the tibia.Methods five cases of congenital pseudarthrosis were treated by the Ilizarov method. Hamartomatous tissue, scar tissue, proliferative periosteum were excised at same time. After onlaying iliac crest grafts, an intramedullary nail was inserted into the canal of proximal and distal site of tibia in order to control the tibia angle and maintain the stability of the ankle.Results Consolidation was obtained in all cases in a mean time of 4 months. Ilizarov frame was removed, 13 months after operation on average. Follow up of 0.6 to 5 years (average time: two years), showed that in 4 cases the pseudarthrosis healed with external fixation removed. 1 cases was cured after two time application of the technique.Conclusions Congenital pseudathosis is still difficulty to treat. We believe it is important to eradicate focus. It is not recommended to treat the nonunion and perform do limb lengthening at the same time. Early operation may have better result than a latter one.