利用Ilizarov外固定架治疗单侧肢体短缩型下肢不等长的临床研究  

Clinical study of Ilizarov external fixator in the treatment of leg-length discrepancy due to unilateral limb shortening

作　　者：杨跃 任志勇 刘增运 汤丽国 YANG Yue;REN Zhiyong;LIU Zengyun(Department of Orthopedics,Sunshine Union Hospital,Weifang,Shandong,261021,China)

机构地区：[1]山东省阳光融和医院,山东潍坊261021

出　　处：《实用手外科杂志》2020年第4期411-414,418,共5页Journal of Practical Hand Surgery

摘　　要：目的本研究旨在探讨应用Ilizarov肢体延长术治疗由单侧肢体短缩所引起的双下肢不等长(leg-length discrepancy,LLD)的临床疗效,为该技术的应用提供更加充实可靠的临床依据。方法对2014年3月-2017年5月间因LLD行患肢Ilizarov肢体延长术的30例患者进行随访。以夏和桃肢体延长评分标准作为疗效的主要评价标准,通过计算骨痂直径率来评价延长骨的生长质量,分别利用Harris髋关节功能评分标准,膝关节HHS、AOFAS踝与后足功能评分标准对患者术后下肢各关节功能的改善状况进行评分,并使用相应的统计学方法进行分析。结果根据夏和桃肢体延长疗效评分标准评定,优20例,良8例,可2例,优良率93.3%。短侧肢体延长长度4.0~13.4 cm,平均7.9 cm,外固定架拆除时间6~15个月,平均10个月,伴有成角畸形者在延长中畸形得到矫正。本次研究中所有并发症经过相应处理得到良好预后。手术拆除外固定架后,首次行下肢X线片测得所有患者的CDR均大于85%。患者术后最终评定的髋关节Harris、膝关节HHS、AOFAS踝与后足功能评分均优于术前,P<0.05,具有统计学意义。结论利用Ilizarov外固定架肢体延长术治疗由单侧肢体短缩引起的LLD是安全有效的。Objective To explore the efficacy of Ilizarov limb lengthening operation on LLD due to unilateral limb shortening,and to provide a more substantial and reliable clinical basis for the application of this technique.Methods Thirty patients who underwent Ilizrov limb lengthening for LLD from March 2014 to May 2017 were followed up.Taking Xia He Tao limb lengthening score as the main evaluation criteria,the growth quality of lengthened bone was evaluated by calculating callus diameter ratios(CDR).The functional improvement of joints was evaluated by Harris hip function score,knee joint HHS,AOFAS ankle and hind foot function score.Results According to the evaluation criteria of limb lengthening efficacy of Xia He Tao,20 cases were excellent,8 cases were good,2 cases were fair,the excellent and good rate was 93.3%.The lengthened length was 4.0-13.4 cm,with an average of 7.9 cm.The removal time of external fixator was 6-15 months,with an average of 10 months.During the lengthening,the deformity was corrected.In this study,all complications were treated accordingly to obtain good prognosis.After removal of the external fixator,the CDR of all patients was more than 85%measured by the first lower limb X-ray film.The final evaluation of hip Harris,knee HHS,AOFAS ankle and hind foot function after operation was better than that before operation,with statistical significance(P<0.05).Conclusion Ilizarov technique is a safe and effective method in the treatment of LLD.

关 键 词：下肢不等长 ILIZAROV技术 肢体延长 

分 类 号：R658.3[医药卫生—外科学]