半骺板阻滞术治疗儿童膝关节成角畸形的矫正速率与临床疗效分析  

Correction rate and clinical efficacy analysis of semi-epiphyseal plate block for treatment of angular deformity of knee joint in children

作　　者：刘岩 吕阳 钟治平 黄泽鑫 许树柴 LIU Yan;Lü Yang;ZHONG Zhi-ping;HUANG Ze-xin;XU Shu-chai(Department of Orthopedics,Ershadao Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine;不详)

机构地区：[1]广东省中医院(广州中医药大学第二附属医院)二沙岛分院骨科,广东广州510105 [2]广东省中医院(广州中医药大学第二附属医院)二沙岛分院影像科,广东广州510105

出　　处：《中国骨与关节损伤杂志》2021年第10期1027-1030,共4页Chinese Journal of Bone and Joint Injury

基　　金：广东省医学科学技术研究基金项目(B2020167)。

摘　　要：目的探讨半骺板阻滞术治疗儿童膝关节成角畸形的矫正速率及临床疗效。方法纳入自2016-03—2018-03采用8字形钢板半骺板阻滞术治疗的22例(36膝)膝关节成角畸形,膝内翻畸形6例(9膝),膝外翻畸形16例(27膝)。测量手术前后膝间距或踝间距、膝关节中心到下肢力线的距离、股胫角,计算矫正速率。结果22例均获得至少2年随访。膝内翻畸形患儿末次随访时膝间距、膝关节中心到下肢力线的距离、股胫角明显小于术前、术后1周和术后3个月,膝外翻畸形患儿末次随访时踝间距、膝关节中心到下肢力线的距离、股胫角均小于术前、术后1周和术后3个月,差异有统计学意义(P<0.05);患儿术前、术后1周、术后3个月上述指标比较差异无统计学意义(P>0.05)。膝内翻畸形患儿矫正速率为(0.32±0.12)°/月,膝外翻畸形患儿矫正速率为(0.48±0.09)°/月,术后9~12个月膝内翻与膝外翻畸形改善效果最明显。膝外翻畸形患儿的矫正速率明显高于膝内翻畸形患儿,差异有统计学意义(P<0.05)。结论半骺板阻滞术治疗儿童膝关节成角畸形效果满意,并发症较少,安全可靠,建议膝内翻畸形患儿矫正速率控制在(0.32±0.12)°/月,膝外翻畸形患儿矫正速率控制在(0.48±0.09)°/月。Objective children’s knee angulation deformities.MethodsTwenty-two cases(36 knees) of knee angulation deformity treated with 8-shaped plate semi-epiphyseal block from March 2016 to March 2018 were included, 6 cases of knee varus deformity(9 knees),and 16 cases of knee valgus deformity(27 knees). The distance between the knees or ankles before and after the operation, the distance from the center of the knee joint to the line of force of the lower limbs, and the femoral tibial angle were measured to calculate the correction rate.ResultsAll 22 cases were followed up for at least 2 years. The distance between the knees, the distance from the center of the knee joint to the line of force of the lower limbs, and the femoral tibial angle at the last follow-up were significantly smaller than those before, 1 week and 3 months after the operation. The distance between ankles, the distance from the center of the knee joint to the lower extremity line of force, and the femoral tibial angle were all smaller than that before operation, 1 week after operation, and 3 months after operation, the difference was statistically significant(P<0.05). There was no statistically significant difference in the above indicators between the children before operation, 1 week after operation, and 3 months after operation(P>0.05). The correction rate for children with knee varus deformity was(0.32±0.12)°/month, the correction rate for children with knee valgus deformity was(0.48±0.09) °/month, knee varus and knee valgus deformity improvement effect was the most obvious in 9-12 months after surgery. The correction rate of children with knee valgus deformity was significantly higher than that of children with knee varus deformity(P<0.05).ConclusionSemi-epiphyseal plate block is satisfactory in the treatment of children’s knee angulation deformity, with fewer complications, and is safe and reliable. It is recommended that the correction rate of children with knee varus deformity be controlled at(0.32±0.12)°/month, and for children with

关 键 词：膝关节成角畸形 膝内翻畸形 膝外翻畸形 半骺板阻滞术 矫正速率 股胫角 

分 类 号：R687.3[医药卫生—骨科学]