Ilizarov技术矫正青少年Blount病的胫骨内翻畸形  

Ilizarov technique for correction of tibial varus deformity secondary to Blount disease in adolescents

作　　者：吴晓林[1] 王业鑫 杨杨[1] 梁答 马振 钟伟[1] WU Xiao-lin;WANG Ye-xin;YANG Yang;LIANG Da;MA Zhen;ZHONG Wei(Department of Joint Surgery,The Affiliated Hospital,Weifang Medical College,Wei-fang 261031,China)

机构地区：[1]潍坊医学院附属医院关节外一科,山东潍坊261031

出　　处：《中国矫形外科杂志》2021年第15期1413-1416,共4页Orthopedic Journal of China

基　　金：潍坊市科技局项目(编号:2020YX038)。

摘　　要：[目的]观察Ilizarov技术治疗青少年Blount病胫骨内翻畸形的临床疗效,探讨青少年Blount病治疗的有效方法。[方法]回顾性分析本科2015年1月—2019年1月手术治疗的7例Blount病肢体畸形青少年患者。胫骨近端截骨后,均采用Ilizarov外固定架逐步矫正胫骨内翻畸形。总结7例患者的临床与影像结果。[结果] 7例患者均顺利完成手术,术后带架时间为8~16周,平均(12.52±2.65)周。仅2例术后早期出现针道感染,经简单清创换药后好转。随访时间(15.43±1.15)个月,7例患者畸形均无复发,平均截骨愈合时间(22.67±5.18)周。与术前相比,末次随访时患者VAS评分显著降低(P<0.05),HSS评分显著增加(P<0.05),膝伸屈ROM无显著变化(P>0.05)。影像方面,与术前相比,末次随访时MAD和TFA显著减少(P<0.05), mMPTA显著增加(P<0.05),PTS无显著变化(P>0.05)。[结论]应用Ilizarov技术对青少年Blount病的胫骨内翻畸形进行渐近式矫治,能够建立正常的下肢力线,是一种有效的方法。[Objective] To observe the clinical outcomes of Ilizarov technique for correction of tibial varus deformity secondary to Blount’s disease in adolescents. [Methods] A retrospective study was conducted on 7 adolescents who underwent surgical treatment for limb deformity secondary to Blount disease in our department from January 2015 to January 2019. After proximal tibial osteotomy, the Ilizarov external fixator was used to correct the tibial varus deformity gradually in all patients. The clinical and imaging consequences of the 7 patients were summarized. [Results] All 7 patients had operation performed smoothly. The frame carrying time ranged from 8 to 16 weeks,with an average of(12.52±2.65) weeks. The tract infection was found only in 2 cases postoperatively, which cured after simple debridement and dressing change. The follow-up period lasted for(15.43±1.15) months on average. No recurrence of the deformity was noted in anyone of the 7 patients, whereas osteotomy healed in all of them in(22.67±5.18) weeks on average. The VAS score was significantly reduced,whereas the HSS score was significantly increased(P<0.05), and knee extension-flexion ROM remained unchanged significantly at the latest follow-up compared with those preoperatively(P>0.05). In terms of imaging, the MAD and TFA were significantly reduced(P<0.05),whereas the mMPTA was significantly increased(P<0.05), and PTS was not significantly changed at the latest follow-up compared with those preoperatively(P>0.05). [Conclusion] It is effective to correct tibial varus deformity gradually by using Ilizarov technique for Blount disease in adolescents, which does resume the normal alignment of the lower extremity.

关 键 词：Blount病 青少年 ILIZAROV技术 渐近式矫治 

分 类 号：R687[医药卫生—骨科学]