“三联方案”预防先天性胫骨假关节胫骨延长治疗后膝关节屈曲挛缩的效果评价  

Efficacy of “triple program”in preventing knee joint flexion contracture in children with congenital pseudarthrosis of the tibia during tibial lengthening

作　　者：邓凤良[1] 谢鑑辉[2] 梅海波[3] 赫荣国[3] 易银芝[3] 张妮[3] 谭炯[3] Deng Fengliang1,Xie Jianhui2,Mei Haibo3,He Rongguo3,Yi Yinzhi3,Zhang Ni3,Tan Jiong3.(1. University of South China,Hengyang 421001,China; 2. Departmentof Nursing, Hunan Childrens Hospital, Changsha 410007, China; 3. Department of Orthopedics, HunanChildrens Hospital,Changsha 410007,China. Corresponding author：Xie Jianhui,Email：907139834＠ qq. Com)

机构地区：[1]南华大学护理学院,湖南省衡阳市421001 [2]湖南省儿童医院护理部,湖南省长沙市410007 [3]湖南省儿童医院骨科,湖南省长沙市410007

出　　处：《临床小儿外科杂志》2018年第7期528-532,共5页Journal of Clinical Pediatric Surgery

基　　金：湖南省卫生与计划生育委员会项目(编号:A2017008)

摘　　要：目的探讨"三联方案"(阶段性功能锻炼、佩戴胫骨延长辅助支具、延长速度个体化)预防先天性胫骨假关节(CTP)胫骨延长治疗中膝关节屈曲挛缩的临床疗效。方法回顾性分析2013年7月至2016年11月间本院收治的42例实施联合手术加胫骨延长治疗的CTP患儿临床资料并对随访结果进行分析。结果 42例均获得完整随访,平均随访8个月(4~17个月),外固定架平均佩戴时间228 d(118~456 d);平均延长长度4.4 cm,早期愈合率100%,平均愈合指数52 d/cm;拆除外固定支架时膝关节功能优40例,良2例;无一例发生血管神经损伤、轴线移位、关节脱位、固定针折断、骨不愈合等。结论 "三联方案"预防CPT胫骨延长治疗后膝关节屈曲挛缩效果良好,值得临床推广。Objective To explore the efficacy of ＂ triple program＂ of staged functional exercise wearingtibial extension auxiliary braces and individualized lengthening for preventing knee joint flexion contracture during tibial lengthening in children with congenital pseudarthrosis of the tibia （CTP）. Methods A retrospectivestudy was performed for 42 CPT patients undergoing surgery plus tibial lengthening from July 2013 to November2016. Results The average followup period was 8（4 - 17） months. The average wearing time of external fixator was 228 （118 - 456） days and the average length of lengthening 4. 4 cm. All patients achieved primary union. The average healing index was 52 d / cm. After removing external fixator,the outcomes of knee functionwere excellent （n = 40） and good （n = 2）. There was no instance of nerve injury,axial displacement,joint dislocation,broken needle or nonunion. Conclusion The “triple program” is effective in preventing flexion contracture of knee joint in CPT children during tibial lengthening. And wider clinical application is recommended.

关 键 词：先天性胫骨假关节 胫骨延长 膝关节 屈曲挛缩 

分 类 号：R726.8[医药卫生—儿科]