Ilizarov技术在治疗大龄儿童僵硬型马蹄内翻足的运用  

The Application of Ilizarov Technology in the Treatment of Stiff Horseshoe Flip in Older Children

作　　者：许权 吴凡 张恒青 杨凤云[1] 李梅[1] XU Quan;WU Fan;ZHANG Heng-qing;YANG Feng-yun;LI Mei(Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330006,China)

机构地区：[1]江西中医药大学附属医院,南昌330006

出　　处：《江西中医药大学学报》2021年第1期62-64,共3页Journal of Jiangxi University of Chinese Medicine

摘　　要：目的:运用Ilizarov技术治疗大龄儿童僵硬型马蹄内翻足,探索其治疗过程及其疗效。方法:选自2013年3月—2017年3月的12例在我院骨科住院的大龄儿童,年龄在6岁至14岁之间,共18足,均被确诊为僵硬型马蹄内翻足,Diméglio分型为Ⅲ型。其中1例合并脊髓栓系综合征,并已行栓系松解手术;9例合并脑性瘫痪;2例病因不明确。术前ICFSG评分结果均为差。给予Ilizarov外固定架逐步矫正足踝部畸形。结果:所有患者均得到1~2年随访,外固定架固定调节时间为3~6月。拆除外固定架后1年,ICFSG评分结果为优10足,良5足,中2足,差1足。优良率达83.33%。ICFSG评分结果为差的脑瘫后遗症患者高足弓症状明显,拆除外固定架后给予软组织松解术及截骨术,术后ICFSG评分结果为优。随访过程中所有患者均未复发。外固定架调节过程中,出现了一些并发症,如踝关节前脱位、针眼感染、患肢远端肿痛、连接杆脱落松动及膝关节活动受限等,通过及时有效的措施,这些并发症都得到了很好的处理。结论:Ilizarov技术治疗大龄儿童僵硬型马蹄内翻足疗效可靠,具有创伤小、复发率低等特点,值得临床推广使用。Objective:To investigate the therapeutic process and its effect of using Ilizarov technique in the treatment of stiff horseshoe varus in older children.Methods:12 children aged between 6 and 14 who were admitted to our orthopaedic hospital from March 2013 to March 2017 were all diagnosed with rigid horseshoes,and Diméglio was classified as Type III.In one case,tethered cord syndrome was combined,and tethered loosening operation was performed.9 cases combined with cerebral palsy.The etiology of 2 cases was unclear.Preoperative ICFSG scores were poor.The malformation of the ankle was gradually corrected by the Ilizarov external fixation.Results:All patients were followed up for 1 to 2 years,and external fixation time was 3 to 6 months.One year after the removal of the external fixed frame,the ICFSG score was excellent 10 feet,good 5 feet,2 feet in the middle,and 1 foot in the difference.The excellent rate reached 83.33%.The ICFSG score was significant for patients with poor cerebral palsy sequelae.After removing the external fixation,soft tissue loosening and osteotomy were given.The ICFSG score after surgery was excellent.All patients did not relapse during the follow-up.During the adjustment process of the external fixation frame,some complications occurred,such as anterior dislocation of the ankle,eye infection,distal swelling and pain of the affected limb,loosening of the connecting rod,and limited knee joint activity.These complications were timely and effective.Get a good deal of treatment.Conclusion:Ilizarov technique is effective and reliable in the treatment of stiff horseshoe varus in older children.It has the characteristics of small trauma and low recurrence rate,and is worthy of clinical application.

关 键 词：ILIZAROV技术 大龄儿童 僵硬型 马蹄内翻足 

分 类 号：R726.8[医药卫生—儿科]