摘要
目的 探讨国产骨外固定器治疗四肢残缺畸形患者的临床效果.方法 回顾性分析1989年1月至2016年6月秦泗河矫形外科团队应用国产骨外固定器治疗各种原因导致的四肢残缺畸形的7 289例患者资料,其中男性4 033例,女性3 256例;年龄2～ 82岁,平均23.4岁.外固定器种类：Ilizarov外固定器2 732例,组合式外固定器4 713例,单臂外固定器57例,其中Ilizarov外固定器与组合式外固定器合用者232例.手术部位：上肢应用Ilizarov外固定器、组合式外固定器和单臂外固定器分别为67例、65例和0例,下肢分别为2 665例、4 616例和57例;手术侧别：左侧肢体3 028例,右侧肢体3 260例,双侧肢体1 001例;疾病种类前三位分别为脊髓灰质炎后遗症、脑性瘫痪后四肢畸形和创伤后四肢畸形;畸形种类包括马蹄内翻足、屈膝畸形、高弓足等.结果 所有患者均获得随访,随访时间2.5个月至22.4年,平均随访时间5.4年.所有外固定器为单次使用器械,未出现因骨外固定器质量原因更换固定器械.除1例中途放弃治疗、1例金属过敏提前拆除外,其余患者皆完成手术治疗目标达到拆除标准后将外固定拆除.常见并发症包括针道感染、关节活动受限等.结论 国产骨外固定器结合中国肢体畸形残障患者的特点研制生产,能够治疗各种原因导致的四肢残缺畸形患者,具有实用、经济、可调、通用、轻便的优势,可满足四肢截骨断段固定、畸形矫正、残缺修复与短缩延长的临床需求.
Objective To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs.Methods A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed.The patients were treated with domestic external fixator,including 4 033 males and 3 256 females,aging from 2 to 82 years with a mean age of 23.4 years.There were 2 732 patients using Ilizarov external fixator,4 713 patients using hybrid external fixator,57 patients using monobrachial external fixator,232 patients using Ilizarov external fixator and hybrid external fixator.The Ilizarov,hybrid and monobrachial external fixator were used in 67,65 and 0 patients on the upper limbs and in 2 665,4 616 and 57 patients on the lower limbs.There were 3 028 patients operated on the left limbs,3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs.The top three types of diseases were sequelae of poliomyelitis,cerebral palsy and post-traumatic stress disorder peromely.Deformity types inclued talipes equinovarus,knee flexion deformity,cavus foot and so on.Results All the patients were followed up for a period of 2.5 months to 22.4 years,with an average follow-up time of 5.4 years.All of the external fixators were used for single once,and there was no substitute for external fixator quality problem.All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy.The common complications included wire or pin infection and joint movement limitation and so on.Conclusions The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability.The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical,economical,adjustable,universal and portable.The domestic external fixator could meet the clinical demand for fixation of the osteotomy end of the limbs,the correction of the deformity,the repair of the defects and the limb lengthening.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2017年第9期678-683,共6页
Chinese Journal of Surgery
关键词
外固定器
四肢
围产
畸形矫正
External fixator
Extremities
Domestic production
Deformity correction
