计算机辅助外固定支架在复杂胫腓骨畸形截骨矫正术中的应用  

Computer-assisted external frame for correction of tibial and fibular deformity

作　　者：陈建文 颜景涛 郭悦 

机构地区：[1]国家康复辅具研究中心附属康复医院骨一科,北京100176

出　　处：《中华创伤骨科杂志》2015年第7期589-593,共5页Chinese Journal of Orthopaedic Trauma

基　　金：国家“十二五”科技支撑计划项目（2012BA133800）

摘　　要：【摘要】目的介绍一种计算机辅助外固定支架在复杂胫腓骨畸形截骨矫正术中的应用。方法回顾性分析2012年1月至2013年12月期间应用计算机辅助外固定支架及配套计算机软件进行胫腓骨复杂畸形截骨矫正术的15例患者资料，均为单侧肢体畸形，其中左下肢8例，右下肢7例。男8例，女7例；年龄15。43岁，平均26．8岁。畸形病因：陈旧性骨髓炎9例，创伤后遗症6例。术后复查下肢X线片，测量各相关角度、距离及旋转等，将数值输入计算机软件算出每个调节支撑螺杆每日调节距离并按结果调节。调节期间患者可自主生活，达到预期要求后拆去外固定支架。结果15例患者术后获10～22个月（平均15个月）随访。外固定支架固定时间平均为8．4个月（5．5～13．1个月），骨折愈合时间平均为8．0个月（5．4—12．1个月）。术后平均住院时间为2．4个月（2．0～2．8个月），10例存在肢体短缩的患者，处方调节结束后短缩长度平均为0．5cm（0～0．9cm）。12例肢体成角患者，处方调节结束后肢体成角畸形为0～5．4°，平均3．3°。5例存在肢体旋转畸形的患者纠正治疗后，内旋最大角度为5°，外旋最大角度为10°，偏离正常值平均3．5006例患者存在水平移位畸形，手术纠正后水平移位距离为0．5cm。所有患者下肢力线矫正满意，症状及外观明显改善，患者对疗效满意。结论应用计算机辅助外固定支架进行胫腓骨复杂畸形纠正可取得满意疗效，并达到畸形矫正简单化、精准化、标准化、微创化的目的，值得推广。Objective To introduce a new computer-assisted external frame for osteotomy to correct complex tibial and fibular deformity. Methods From January 2012 to December 2013, 15 patients with complex tibial and fibular deformity were treated with a computer-assisted external frame and related computer software for surgical correction. All were unilateral limb deformity, involving the left lower limb in 8 cases and the right lower limb in 7 cases. They were 8 males and 7 females, 15 to 43 years of age （average, 26.8 years）. The deformity was caused by old osteomyelitis in 9 cases and trauma sequela in 6. The related angles, distances and rotations were measured on the postoperative radiographs of the lower limbs. The data were input into the software to calculate the daily adjustment lengths of the frame rods. Daily frame adjustments were conducted according to the data calculated. The frame was removed when expected results were achieved. The patients lived independently during the adjustment. Results The 15 patients were effectively followed up for 10 to 22 months （average, 15 months） . Frame fixation time averaged 8.4 months （from 5.5 to 13.1 months）. The reunion time averaged 8.0 months （from 5：4 to 12. 1 months）. The hospitalization time aver- aged 2.4 months （from 2.0 to 2. 8 months）. In 10 cases of limb shortening, the shortening lengths averaged 0. 5 cm （from 0 to 0. 9 cm） after adjustment. In 12 cases of angulation deformity, the angulation averaged 3.3° （from 0° to 5.4°） after adjustment. In 5 cases of rotation deformity, the maximum internal rotation was 5° and the maximum external rotation 10° after correction, deviating from the normal values by 3.5° on average. In 6 cases of horizontal displacement, the displacements averaged 0.5 cm after correction. All patients were satisfactory with corrected lower limb alignment, improved symptoms and appearance, giving a subjective satisfaction rate of 100%. Conclusion Use of computer-assisted external frame in surgical correction o

关 键 词：外固定器 胫骨 腓骨 截骨术 

分 类 号：R687.3[医药卫生—骨科学]