半环槽式外固定架结合Ilizarov技术在骨科临床的应用

目的：探讨应用半环槽式外固定架结合Ilizarov技术治疗肢体缩短畸形及骨缺损的手术方式和经验。方法：单纯下肢短缩畸形者，分别采用股骨远端、胫骨近端或胫骨远端施行干骺端横行截骨，半环槽式外固定架缓慢牵伸逐渐延长：骨缺损、骨不连、假关节形成、肢体短缩者，除行干骺端截骨延长外，还必须将假关节处两骨端予以修正，使之略成“V”形互相对合嵌插，并加压固定。结果：35例患者骨延长3～17cm，平均延长7．5cm，合并成角畸形者同时得到纠正．其中11例有骨缺损、骨不连、假关节形成者均得到良好愈合。结论：半环槽式外固定架结合Ilizarov技术治疗肢体短缩畸形及骨缺损，具有方法简单、手术创伤小、不需要植骨、固定可靠、并发症少、疗效满意等优点，值得推广应用。

Treatment of lower limb shortening and bony defects with semicircle external fixator

Objective： To evaluate the treatment of lower limb shortening and bony defects with semicircle external fixators. Methods： For the patients with simple lower limb shortening deformity,we performer metaphysis osteotomy at distal femur,proximal tibia or distal tibia according to different cases before we extended the limb with gradual traction with the semicircle external fixator;for the patients of bony defect,nonunion of fracture,pseudarthrosis and limb shortening,a corticalosteotomy of the pseudarthrosis was performed in addition to the metaphysis osteotomy and extension to make the ex- tremities of the pseudarthrosis in ＂V＂ Shape and compressed with the external fixation. Results：The bone wans lengthened 3-17cm in 35 patients,with the average extension being 7.5cm. The angulation deformity was corrected at the same time. 1 leases of the bony defect,nonunion and pseudarthrosis healed well. Conclusion： In treatment of lower limb shortening and bony defects,the semicircle external fixator is worth recommending because it is simple to use,less traumatic,reliable,and gives rise to fewer complications,good effects,and no need of bone grafting.