外固定器治疗青少年伴有肢体短缩的膝外翻畸形

目的:探讨运用外固定器行骨痂延长术治疗青少年严重的膝外翻畸形合并肢体短缩的疗效及经验,为临床选择合理的治疗方法提供依据。方法:回顾性分析了2002年1月至2009年1月采用外固定器对28例青少年膝外翻畸形并肢体短缩行骨痂延长术治疗的资料。男17例,女11例,年龄8～14(平均11.9)岁,双膝外翻者3例,共31个膝。术前患侧肢体短缩3～7(平均4.1) cm;股胫角138°～160° (平均148°),踝间距5～33(平均15.2) cm。结果:全部病人均获随访。随访35～84(平均62)个月,延长范围4.5～10.1(平均6.8) cm。愈合后股胫角169°～175° (平均173°)。所有患者双下肢几乎等长,严重外翻畸形得到纠正。结论:骨外固定器行骨痂延长术是治疗青少年伴有股骨短缩的膝外翻畸形的有效方法。

Treatment of external fixator in young patients with valgus deformity of the knee companied with leg shortening

Objective: To explore the efficacy and experience of callus distraction technique with the external fixator for valgus deformity of the knee companied with leg shortening in young patients and to provide evidence for selecting reasonable therapy. Methods: From January 2002 to January 2009, the clinical data of 28 young patients (17 males and 11 females, aged 8 to 14, mean age 11.9 years) treated with callus distraction, who had valgus deformity of the knee, companied with leg shortening, were analyzed retrospectively. Three had bilateral total valgus deformity of the knee, with a total of 31 knees. Before the operation, the abnormal limbs shortened from 3 to 7 cm (average 4.1 cm) companied with the normal one. The tibiofemoral angle ranged from 138? to 160? (mean angle 148?) and the Condyle interval from 5 to 33 cm (mean interval 15.2 cm). Results: The 28 patients were followed up for 35 to 84 ( mean 62 ) months. The extent length ranged from 4.5 to 10.1 cm (average 6.8 cm). The tibiofemoral angle ranged from 169? to 175? (mean 173?) after the union. The patients resumed the normal length of limbs, and the severe valgus deformity of the knee was corrected. Conclusion: Callus distraction with external fixator is effective for serious valgus deformity of the knee companied with leg shortening.