延长骨的骨痂形态与并发症之间的关系

目的：研究延长骨的不同X线形态及其在延长过程中不同阶段的发展，推断出延长骨的骨痂类型与并发症之间的关系。方法：分析40例均为1990－2001年间在我院行Ilizarov技术肢体延长术患儿的X线片，根据骨痂的横径和低密度区或带的出现分类。结果：在延长结束期截骨部位影响骨痂的横径，在治疗结束前发现全部X线片均表现为不良骨痂形态的都是有干部位截骨，在术后5周和延长结束期最常见的并发症是成角畸形，在治疗末期骨痂的横径和低密度带的出现与并发症有着密切的关系。结论：在外固定解除前延长骨痂带有不完全的骨小梁结构和低密度区发生骨折的危险很高。骨痂带有轴向偏移、低密度区、不充分的横径在延长的整个过程中必须采取相应的措施以确保延长骨良好的愈合。

Relationship between callus pattern and complications of bone lengthening

Objective To study the radiographic morphology of lengthened bone regeneration during development and establish a possible relation between the callus patterns and complications.Methods Radiographs of 40 patients ( male 24, female 16) who underwent Ilizarov limb lengthening operation between 1991 and 2001 were analyzed. The patients aged from 3 to 17 years with a mean of 8.5 years.The callus pattern was classified according to its transverse diameter and density.Results The level of osteotomy influenced on the callus and its transverse diameter. All patients with poor bone formation at the end of treatment were found to have undergone a diaphyseal osteotomy. The most common complication at the five weeks and at the end of distraction was angulation. The diameter of the callus and the presence of bands at the end of treatment were closely related to the complications.Conclusions Lengthened callus with incomplete trabecular formation and low density areas or band have a high risk of fracture at the end of treatment. Callus with axial deviation, low density areas or an insufficient transverse diameter during the lengthening procedure must be treated carefully.