先天性胫骨假关节45年的治疗经验  

45 years experiences of treatment of congenital pseudarthrosis of the tibia

作　　者：孙琳[1] 潘少川[1] 孙保胜[1] 于凤章[1] 张学军[1] 祁新禹[1] 李成鑫[1] 邓京城[1] 贾和庚[1] 

机构地区：[1]首都医科大学附属北京儿童医院,教育部儿科重大疾病重点实验室,北京市小儿外科矫形器具工程研发中心,北京100045

出　　处：《山东医药》2012年第36期13-16,104,共5页Shandong Medical Journal

摘　　要：目的总结45年期间,3个阶段、3种方法、20例先天性胫骨假关节(CPT)患儿的治疗经验。方法我们医院对CPT先后采用了单纯植骨融合术(1956～1977年,5例),游离带血管蒂腓骨移植手术(1977～1990年,7例)和Ilizarov技术和外固定器(1990～2007年,8例)3种方法。结果 20例患儿中15例假关节愈合,治愈率为75%,有2例为愈合后再骨折,治疗后重新愈合。结论对CPT的治疗效果,以游离带血管蒂腓骨移植手术与Il-izarov技术和外固定器较好,两者均较早期的单纯植骨融合方法疗效提高。但3种方法结合应用效果最佳。目前为止,对CPT的治疗仍有很多问题需要解决,例如膝外翻、踝外翻、胫骨再骨折、治疗时间过长等。Objective Analysis the 45 years experiences of treatment on congenital pseudarthrosis of the tibia in Beijing children＇ s hospital respectively, inclouding three methods, three stages. Methods A total of 20 patients with congenital pseudarthrosis of tibia were admitted to Beijing Children＇s Hospital from 1956 to 2007. Five patients had have various tech- niques of bone graft in the early stage, seven free pedicle grafts of fibula had been performed in coorperation with the microsurgeon since 1977. The Ilizarov technique and device was adopted since 1990. Results The follow-up time was 5 years at least. A total of 15 patients in 20 cases with congenital pseudarthrosis of tibia healing evently in this group, the healing rate was 75%. Conclusions The unions were sound and the healing rate was also impressively high. However, some problems still remain unsolved,such as the genu valgum, ankle valgum, refrecture of tibia and the longtime of treatment.

关 键 词：先天性胫骨假关节 治疗 游离带血管蒂腓骨移植手术 Ilizarov技术和外固定器 植骨融合 

分 类 号：R687.3[医药卫生—骨科学]