骨痂延长术在小腿短缩中的应用及并发症防治  

Clinical outcome and complication of callastasis of tibias in treatment of short legs

作　　者：付晓玲[1] 张湘生[2] 邱睿韫[3] 殷明[1] 吴凯[1] 

机构地区：[1]南昌大学第二附属医院骨一科,江西南昌330006 [2]中南大学湘雅附二医院骨二科,湖南长沙4100000 [3]南昌大学信息工程学院,江西南昌330000

出　　处：《中国现代医学杂志》2011年第10期1209-1211,1215,共4页China Journal of Modern Medicine

摘　　要：目的探讨骨痂延长术在小腿短缩的临床效果及并发症防治。方法自2000年～2005年共收治先天性小腿短缩患者9例,平均年龄24岁(20～27岁),平均短缩5.5 cm(5.0～6.2 cm),应用外固定支架结合髓内钉进行延长,术中均未进行植骨,术后第5天开始延长,延长速度1 mm/d,频率4～6次/d,并定期复查X片观察延长段骨痂生长情况,延长长度达预定长度后,拆除外固定支架,骨愈合后拆除髓内钉,对治疗过程中出现的并发症进行记录,探讨并发症的防治,并根据ENNEKING等的下肢功能评价系统进行评价。结果所有患者均获得随访,平均随访时间37个月(32～40个月),平均延长5.4 cm(4.8～6.2 cm),平均延长率:23.5%(18.5%～30.0%),骨愈合时间40 d/cm,9例患者均有不同程度的足下垂、内翻,应用中药熏洗手法推拿按摩治疗后治愈,根据ENNEKING等的下肢功能评价系统进行评价:优6例,良3例,差0例。随访过程中未出现再骨折、骨髓炎、神经血管损伤等并发症。结论应用外固定支架结合髓内钉进行骨痂延长术是治疗先天性小腿短缩的有效方法,但需要术前严密安排,术中谨慎操作,术后严密观察手术并发症及钉道护理。【Objective】 To investigate the clinical outcome and complication of callastasis of tibias combined external fixator and intramedullary nail in treatment of short legs,and express the experience.【Methods】 9 patients of short leg were treated with callastasis combined external fixator and intramedullary nail from 2000 to 2005,4 are male and 5 female,with an average age of 24 years old（20~27）.Lengthening was started 5 days post-operative,the lengthening protocol was 1mm every 4~6 hours.Once the expected length was achieved,the nail was removed.The fixator was removed after total bone healing.【Results】 The mean follow-up was 37 months（range from 32~40）,The average amount of lengthening was 5.4 cm（range： 4.8~6.2 cm）,and the proportion of achieved lengthening was 23.5%（range： 18.5%~30.0%）.The average healing index was 40 day/cm.No refracture or vessel injury was discovered during follow-up.According to Enneking system： 6 was well,3 was good.【Conclusion】 Callastasis of tibia combined external fixator and intramedullary nail was an effective method in treatment of short legs.

关 键 词：骨痂延长术 小腿短缩 

分 类 号：R682.6[医药卫生—骨科学]