一期延长矫正下肢22cm巨大短缩畸形

下肢巨大短缩的治疗和康复极为困难。本文报告用股、胫骨同时延长，一期矫正下肢22cm巨大短缩。患者为13岁女孩，右股骨短缩17cm，同时骨不连，右胫骨短缩5cm。作者采用股骨粗隆下截骨与胫骨下端骨骺牵伸、缓慢的逐渐延长，加压外固定治疗骨不连。结果2个月延长胫骨6cm，131天延长股骨16cm，骨不连同期愈合。未发生神经与血管损伤，亦未植骨与内固定。患肢用外固定器固定10个月和单侧石膏裤4个月，术后16月练习患肢负重，19月股骨已重建髓腔，患儿开始扶杖上学。作者认为本例治疗成功的关键因素是延长平面选择合理，缓慢的逐渐延长和骨端牢稳固定。

one-stage correction of a 22cm leg length discrepancy bysimultaneous lengthening of femur and tibia

The correction nnd rehibitation of huge leg length discrepancies is extremely difficu lt. The authors reported a 13-year old girl with a 22cm leg length discrepancy (femur 17em, tibia 5cm ) and concomitant non-union at distal portion of right remur. This case had been treated by subtrochanteric lengthening osteotomy and epiphyseal distr-iction on the distal epiphysis of tibia. Femur and tibia gained 16cm and 6cm respectively in one stage (131day) . The non-union was treated by compression external foxation and resulted in bony union. NO bone grafting and no internal fixation had been needed. No aerve and vessele complications has been found. The operated leg on was treated with mul-tiple plane external skeletal fixation for 10 months and hip spica of plaster of paris for 4 months. Follow-up of the patient for 19 nonths revealed that the lengthened leg was capable body weigt bearing her 16 months postoperatively. 19 months after operation, medullary canal of the femur had been recons tructed, and the patient went to school with the aid od crutches. The key factors of successful treatment in this case seemed to be:reason able selection of lengthening sites, slow and gradual lengthening, and stability of exernal fixator.