不同骨延长器治疗肢体畸形并大段骨缺损.doc

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1、不同骨延长器治疗肢体畸形并大段骨缺损作者：袁天祥，马宝通，赵宝成，张金利，曹清，孙杰，夏群，金鸿宾【关键词】,肢体畸形摘要：［目的］利用Ilizarov支架、Orthofix肢体重建系统(OrthofixLRS)及Hybrid固定系统(HybridFixationSystem)与OrthofixLRS的组合，对不同的肢体畸形并大段骨缺损进行矫形及骨延长治疗，同时观察其疗效。［方法］自2000年8月～2004年3月分别用Ilizarov支架、OrthofixLRS及Hybrid支架与OrthofixLRS的组合进行骨痂牵开／骨段滑移治疗合并肢体畸形的大段骨缺损。畸形处采用线形

2、／楔形截骨。畸形愈合并骨短缩者楔形截骨后进行骨痂牵开骨延长术，骨不连并畸形及短缩者接合点加压与截骨矫形骨段滑移延长同时进行。［结果］矫正股骨短缩畸形7cm1例，胫骨6例，内翻畸形2例，后成角畸形2例，混合畸形2例。平均延长53cm(45～7cm)，平均延长时间35个月，平均延长后外固定时间7个月，无神经血管损伤，膝踝关节活动未受影响。［结论］Ilizarov支架、OrthofixLRS、Hybrid固定系统与OrthofixLRS的组合用于骨痂牵开／骨段滑移治疗合并肢体畸形的大段骨缺损均能达到矫形及骨延长的治疗目的。OrthofixLRS及Hybrid固定系统与Orthof

3、ixLRS的组合较Ilizarov支架操作简便，安全可靠，患者乐于接受。关键词：骨延长器；肢体畸形；骨缺损；骨段滑移Abstract：［Objective］Tostudythecorrectionofdeformitywithmajorbonedefectbylengtheningwithdifferentexternalfixatorsandtoevaluatetheresults.［Method］FromAugust2000toMarch2004,7patientssufferingfromdeformitywithmajorbonedefectweretreatedb

4、yexternalfixatorsincludingIlizarov,OrthofixLRS,andHybridexternalfixatorscombinedwithOrthofixLRS.Linarorwedgedosteostomywascarriedoutatthedeformitysite.Wedgedosteotomyandcallusdistractionwereusedforthecasesofdeformitywithlimbshortening,andcompressionofdocksitecombinedwithbonetransportwasuse

5、dforthoseofdeformitywithbonedefectandshortening.［Result］Thecasescorrectedwere:1femurwithanteriorangulardeformityand7cmshortening,and6tibiaeincluding2varusdeformities,2posteriorangulardeformities,and2complexdeformities.Theaveragelengthwas5.3cm(4.5～7cm),withanaveragedistractiontimeof3.5month

6、sandfollowedbyanaveragetimeofexternalfixationof7months.Therewerenoobviouscomplications,suchasvascularandnerveinjuries.Thefunctionoftheadjacentkneeandanklewasnotaffected.［Conclusion］ExternalfixatorsincludingIlizarov,OrthofixLRSandHybridexternalfixatorsmay5provideoneofgoodalternativesforcorr

7、ectionofdeformitywithmajorbonedefect.ComparedwithIlizarov,OrthofixLRSandHybridexternalfixatorsaremoreconventional,moreadvantaged,andpreferred,especiallyforitsdistinctclampwhichcanprovidemultiplanefixationandcorrectthedeformitysimultaneouslywithlimblengthening.