环形外固定器矫正多发性内生软骨瘤胫骨畸形  

Tibia deformity correction by circular external fixator in multiple enchondromatosis

作　　者：胡新永[1] 王义生[1] 殷力[1] 陈建文 苏章淼 刘伯鑫 于凤章 

机构地区：[1]郑州大学第一附属医院骨科河南省高等学校临床医学重点学科开放实验室,450052 [2]国家康复辅具研究中心附属康复医院骨科,北京100176

出　　处：《中华实验外科杂志》2017年第1期146-149,共4页Chinese Journal of Experimental Surgery

基　　金：国家十二五科技支撑计划重点项目（2012BA133806）

摘　　要：目的探讨环形外固定器矫正多发性内生软骨瘤胫骨内翻和短缩畸形的治疗效果。方法分析31个多发性内生软骨瘤导致胫骨内翻和短缩畸形的儿童患者临床和术后随访资料。28例患者中，12个男性胫骨，19个女性胫骨，平均年龄12.3岁。采用微创开放胫腓骨截骨环形外固定器缓慢矫正胫骨内翻和短缩畸形，术后1、2、3、6、12、36个月随访，对术前和术后12、36个月的胫骨短缩、膝内翻角度、胫骨近端内侧角、胫骨远端外侧角的改变进行评价，同时不锈钢针穿过软骨瘤体术后12个月和36个月的最大长度和宽度与术前比较。结果与术前比较，术后12、36个月的胫骨短缩从（35.16±8.62） mm分别降低至（16.04±2.73） mm和（6.99±1.93） mm，差异均有统计学意义（t＝15.927，P＝0.000；t＝20.814，P＝0.000）；术后12、36个月的膝内翻角度从（25.0±7.9）°分别降低至（2.1±0.9）°和（5.0±1.1）°，差异均有统计学意义（t＝15.955，P＝0.000；t＝13.843，P＝0.000）；术后12、36个月的胫骨近端内侧角从（70.6±3.0）°分别升高至（88.7±1.6）°和（87.6±1.4）°，差异均有统计学意义（t＝－26.806，P＝0.000；t＝－28.591，P＝0.000）；术后12、36个月的胫骨远端外侧角从（131.5±2.9）°分别降低至（88.9±1.9）°和（89.3±1.8）°，差异均有统计学意义（t＝78.459，P＝0.000；t＝71.467，P＝0.000）。术后12个月和36个月软骨瘤体最大长度分别是（47.2±24.0） mm和（46.6±24.1） mm，与术前（46.2±23.7） mm比较，差异均无统计学意义（t＝－1.808，P＝0.081；t＝－0.741，P＝0.464）。术后12个月和36个月软骨瘤体最大宽度分别是（34.6±6.3） mm和（35.1±5.1） mm，与术前[（33.9±5.0） mm]比较，差异均无统计学意义（t＝－1.014，P＝0.319；t＝－1.910，P＝0.066）。所有患者均未发生骨髓炎，未出现神经血管损伤的症状。结论环形外�Objective To discuss the outcomes of tibia varum and shorting deformity correction by circular external fixator in multiple enchondromatosis. Methods Thirty-one tibias treated with varum and shorting deformity correction by circular external fixator in multiple enchondromatosis were statistically analyzed. Of 31 tibias （28 cases）, 12 were from boys, and 19 from girls, with an average age of 12.3 years. After open tibia and fibula osteotomy through small incision, all tibia varum and shorting deformity were corrected slowly by circular external fixator. The patients were followed up for 1, 2, 3, 6, 12, 24 and 36 months after the operation. Preoperative and postoperative data at 12th and 36th month about tibia shorting deformity, angle of varus knee, medial proximal tibial angle, lateral distal tibial angle, the maximum length and width of the tumors which had been gone through by stainless steel needles were analyzed. Results As compared with the preoperative group whose tibia shorting deformity was （35.16±8.62） mm, postoperative tibia shorting deformity at 12th and 36th month was （16.04±2.73） mm and （6.99±1.93） mm respectively, the difference between the two groups had statistical significance （t=15.927, P=0.000; t=20.814, P=0.000）. As compared with the preoperative group whose angle of varus knee was （25.0±7.9）°, postoperative angle of varus knee at 12th and 36th month was （2.1±0.9）° and （5.0±1.1）° respectively, the difference between the two groups had statistical significance （t=15.955, P=0.000; t=13.843, P=0.000）. As compared with the preoperative group whose medial proximal tibial angle was （70.6±3.0）°, postoperative medial proximal tibial angle at 12th and 36 month was （88.7±1.6）° and （87.6±1.4）° respectively, the difference between the two groups had statistical significance （t=-26.806, P=0.000; t=-28.591, P=0.000）. As compared with the preoperative group whose lateral distal tibial angle was （131.5±2.9）°, postoperative lateral distal

关 键 词：多发性内生软骨瘤 胫骨 环形外固定器 

分 类 号：R738[医药卫生—肿瘤]