肢体延长的起源、理论突破与技术进展  

The origin,theoretical breakthrough and technical progress of limb lengthening

作　　者：秦泗河 臧建成 Dror·Paley Qin Sihe;Zang Jiancheng;Dror Paley(Orthopaedic department of Rehabilitation hospital,National Research Center for Rehabilitation Technical Aids,Key Laboratory of Rehabilitation Technical Aids Technology and System of the Ministry of Civil Affairs,Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability,Beijing 100176,China;Paley Orthopedic and Spine Institute,West Palm Beach,Florida,USA)

机构地区：[1]国家康复辅具研究中心附属康复医院矫形骨科,民政部康复辅具技术与系统重点实验室,北京市老年功能障碍康复辅助技术重点实验室,100176 [2]Paley Orthopedic and Spine Institute,West Palm Beach,Florida,USA

出　　处：《中华骨科杂志》2020年第11期749-754,共6页Chinese Journal of Orthopaedics

基　　金：民政部康复领域重点实验室运行经费资助项目(120603020020)。

摘　　要：Ilizarov技术催生了骨再生和肢体延长,是20世纪骨科发展的重要里程碑之一。进入21世纪,随着进化论、系统控制论、再生医学、人工智能、3D打印等参入临床,突破了既往骨科的范畴,从头颅、脊柱、骨盆、手指、足趾以及神经性溃疡,缺血性坏疽等几乎都能实施再生、修复与重建,进一步证明了生物力可激发人体组织自我修复的潜能。本文追溯了肢体延长术100多年的历史,阐述了最初的截骨、延长理念和Ilizarov技术、牵拉成骨技术以及牵拉成组织技术等重要的生物学理论及其在前苏联,欧洲,北美等世界范围内的传播与发展;介绍了从Wagner、Bastiani、Orthofix、Ilizarov外固定器到全髓内骨骼延长钉等手术器械的优势、劣势和改良;展示了牵拉成组织技术跨越多学科、不同组织再生重建的临床应用。在肢体延长不断发展的历史过程中,国际肢体延长与重建学会以及各国学术组织发挥着重要的推动作用。中国的肢体延长起源与发展可分为四个阶段,即Ilizarov技术前期即骨外固定自主研发和肢体弹性延展延长期、Ilizarov牵拉成骨延长技术期、后Ilizarov技术时代以及应力调控主导下的肢体再生延长与重建期,目前已进入了快速发展的新时代。Ilizarov technology,which led to bone regeneration and limb lengthening,was one of the important milestones in the development of orthopedics in the 20th century.With involving in clinical of evolution,system cybernetics,regenerative medicine,artificial intelligence,3D printing in the 21st century,the usual orthopaedic category was broken through.The skull,spine,pelvis,fingers,toes and neuropathic ulceration,ischemic gangrene almost can implement regenerate,repair and reconstruction,which further proof that the biological force can inspire the potential of the human tissue regeneration.This paper traced the history of limb lengthening for more than 100 years,expounded the original bone osteotomy,lengthening concept and important biological theory of Ilizarov technique,distraction osteogenesis and distraction histogenesis,and their development in the former Soviet Union,Europe,North America and all over the world.The strengths,weaknesses and continuous improvement of Wagner,Bastiani,Orthofix,Ilizarov fixator and lengthenable intramedullary nail were introduced,and clinical application of different tissue regeneration and reconstruction caused by distraction histogenesis were described in this paper.International Society for Limb Lengthening and Reconstruction and the academic organizations of various countries play important roles in promoting process of continuous development of limb lengthening.The origin and development of limb lengthening and reconstruction in China can be divided into four stages:the stage before Ilizarov technology,namely the independent research and development of external fixation;the stage of Ilizarov technology period of distraction osteogenesis;the stage post-Ilizarov;and the stage of limb regeneration and reconstruction under stress control and regulation,which has now entered a new era of rapid development.

关 键 词：骨延长术 骨重建 伊利扎罗夫技术 骨生成 牵张 

分 类 号：R687.3[医药卫生—骨科学]