骨痂牵拉术延长下肢疗效及影响因素分析

目的：评价骨痂牵拉术延长下肢的临床疗效，并探讨延长过程中骨愈合的影响因素及并发症的防治。方法：收集行下肢延长术病例38例(54肢)，其中行增高术者，16例(32肢)、单侧肢体延长者22例，观察临床疗效，分析相关指标。结果：随访时间1～5年，平均2．3年。增高术组平均延长长度为5．2cm，平均延长指数为31d／cm；单侧肢体延长组平均延长长度为5．7cm，平均延长指数为33d／cm。并发症包括关节僵硬50关节、轴向偏移4肢、早期融合2肢、延迟愈合3肢、再骨折2肢、马蹄畸形2肢、关节脱位1肢、针道感染46肢及心理障碍1例。结论：利用Ilizarov生物学原理进行肢体延长疗效确切，但有较多合并症，以关节僵硬及针道感染较为常见。临床工作中合理驾御影响因素、积极预防并发症的发生是提高下肢手术疗效的关键。

Analysis of Affecting factors on the Outcome of Lower Limb Lengthening

Objective: To evaluate affecting factors on the outcome of lower limb lengthening. Methods: Thirty-eight cases (54 limbs)which undergone Ilizarov lower limb lengthening procedures were collected and analyzed. The data included 16 cases (32 limbs) of bilateral-limb-lengthening and 22 cases of unilateral-limb-lengthening. The clinical outcome was observed and the related factors were analyzed. Results: The follow-up time were 1-5 years, averaged 2. 3 years. The average lengthening in heightened group were 5. 2cm, and the lengthening index averaged 31 days/cm. The average lengthening in unilateral limb lengthening group were 5.7cm, and the lengthening index averaged 33days/cm. Complications included 50 joints stiffness, 4 axial deformities, 2 premature union limbs, 3 delayed consolidations, 2 renewal fractures, 2 horse-hoof deformities, 1 dislocation of the ankle, 46 local infections and 1 mental disorder. Conclusion: The outcome of limb lengthening under Ilizarov principle is reliable. But it also has many complications, which mainly consist of joint stiffness and local infections. Harnessing the influenced factors and decreasing the complications is the key to get a satisfactory outcome in practice.