摘要
目的探讨新型儿童可延伸髓内棒治疗儿童先天性胫骨假关节(congenital pseudarthrosis of the tibia,CPT)的临床疗效。方法设计一种新型儿童可延伸髓内棒。收集2019年4月至2020年10月在湖南省儿童医院采用新型儿童可延伸髓内棒联合手术治疗的15例CPT患儿临床资料。其中男9例,女6例;左侧6例,右侧9例;手术时平均年龄35.5个月(19~72个月)。12例伴神经纤维瘤病1型,4例伴胫骨近端发育不良。随访时评估胫骨假关节初期愈合情况,胫骨近端外翻畸形、胫骨长度、踝外翻、踝关节功能及髓内棒移位情况等。结果15例患儿均获随访,平均随访时间13.2个月(10~20个月);14例获得初期愈合(14/15),平均愈合时间4.3个月(3.5~5.5个月)。10例存在胫骨不等长,平均相差0.9 cm(0.4~2.0 cm)。7例发生胫骨近端外翻,1例发生踝外翻(17°),踝关节活动范围平均背伸23°(20°~30°),平均跖屈42°(40°~50°)。本组患儿采用新型可延伸髓内棒平均延伸长度1.6 cm(0.4~3.4 cm),7例发生可延伸髓内棒移位,无一例骺板栓系或再骨折发生。结论新型儿童可延伸髓内棒设计合理,可随胫骨生长实现延伸,无骺板栓系、再骨折并发症发生,手术操作简单,可为先天性胫骨假关节治疗提供一种新的髓内固定选择。
Objective To explore the initial efficacy of a new telescopic rod in the treatment of congenital pseudarthrosis of tibia in children.Methods A new type of telescopic rod for children was designed and its clinical results were evaluated.There were 9 cases of congenital pseudarthrosis of tibia on the right and 6 cases on the left;There were 6 females and 9 males.The average operative age was 35.5(19-72)months.There were 12 cases with neurofibromatosis type 1 and 4 cases with proximal tibial dysplasia.Initial healing of tibial pseudarthrosis,proximal tibial valgus deformity,tibial length,ankle valgus,ankle function and intramedullary rod displacement were evaluated during follow-ups.Results During a follow-up period of 13.2(10-20)months,14 cases achieved initial healing(14/15),with an average healing time of 4.3(3.5-5.5)months.Ten cases had unequal length of tibia,with an average of 0.9(0.4-2.0)cm.Proximal tibial valgus occurred in 7 cases and ankle valgus(17°)occurred in 1 child.The average range of motion of ankle joint was 23°(20°-30°)and the average plantar flexion 42°(40°-50°).The average extension of new telescopic rod was 1.6(0.4-3.4)cm.The displacement of telescopic rod occurred in 7 cases,there was no epiphyseal plate tethering and re-fracture.Conclusion New children's telescopic rod has reasonable design and can extend with the growth of tibia.There are no complications of epiphyseal plate tethering and re-fracture.The operation is simple.It provides a new choice of intramedullary fixation for the treatment of congenital pseudarthrosis of tibia.
作者
刘尧喜
谭谦
刘昆
伍江雁
谢鑑辉
杨戈
黄一勇
朱光辉
梅海波
Liu Yaoxi;Tan Qian;Liu Kun;Wu Jiangyan;Xie JianHui;Yang Ge;Huang Yiyong;Zhu Guanghui;Mei Haibo(Department of Pediatric Orthopedics,Hunan Children's Hospital,Changsha 410007,China)
出处
《临床小儿外科杂志》
CAS
CSCD
2022年第10期953-957,共5页
Journal of Clinical Pediatric Surgery
基金
湖南省卫生健康委一般指导课题(D202304078395)
湖南省自然科学基金青年基金(2021JJ40271)
湖南省儿童医院“1233人才工程”青年人才、国家临床重点专科建设项目-湖南省儿童医院儿科外科(湘卫医发[2022]2号)
湖南省科卫联合基金(2022JJ70007)
关键词
胫骨
假关节
矫形外科手术
内固定器
治疗结果
儿童
Tibia
Pseudarthrosis
Orthopedic Procedures
Internal Fixators
Treatment Outcome
Child
