吴其常 苗旭漫 王东生 解放军第208医院骨科，吉林 长春 130062 临床骨科杂志 1999 0 2 2


    关键词：肢体不等长； 骨延长术；腿长不等 期刊 lcgkzz 0 临床研究 fur -->


    

【摘要】 目的 提高严重肢体不等长的治疗效果，减少术后并发症。方法 治疗50例患者，比较不同平面的骨干延长、不同截骨方式、不同延长速度和频率的疗效。结果 平均延长9.5 cm，其中单段最长16 cm，分段最长18 cm。随着长度增加，可出现肘、膝屈曲挛缩。原有足下垂者，18例畸形加重，其中16例作了跟腱延长或三关节融合术。胫骨骨端与骨骺延长发生胫骨平台倾斜各1例，经截骨矫正。5例愈合不良或不愈合，经补充植骨治愈。结论 骺端延长、开放横断截骨、一次性快速延长是产生多种并发症的原因。实施靠近骨端的骨干延长，保留内骨膜的皮质骨截骨，成人每天1.0 mm、儿童每天1.5～2.0 mm的连续延长，可获得理想的肢体长度、良好的骨痂生长速度和质量以及满意的关节功能。

    【中图分类号】 R687.3；R682

Curative effect of 50 cases of severe limb length inequality

Wu Qichang, Miao Xuman, Wang Dongsheng

(Department of Orthopaedics, The 208th Hospital of PLA, Changchun, Jilin 130062)

【Abstract】 Objective To improve curative effect and decrease the post-operative complications. Methods The effect was compared in 50 patients treated by such methods as different level bone shaft lengthening, different osteotomy, different lengthening speed and frequency. Results 9.5 cm was lengthened averagely, the maximal length of single lengthening and of separate lengthening was 18 cm and 16 cm. With the length increasing, elbow or knee joint may have inflexion and contracture. Among patients with drop foot, 18 cases had progressive deformity, 16 received lengthening of achilles tendon or three joints fusion. 1 case with lengthening of bone end had tibial plateau tilt and 1 case with lengthening of osteoepithysis also had tibial plateau tilt. 5 cases with malunion or nonunion had union through replacement bone-grafting. Conclusion Suitable operation combination, bone shaft lengthening nearing bone end, keeping endosteal cortical bone osteotomy, and a continual lengthening of 1.0 mm^. d^- for adults and 1.5～2.0 mm^. d^-1 for children can get ideal limb length, quality and fast callus development and satisfactory joint function.

    【Key words】 limb length inequality; bone lengthening; leg length inequality

肢体不等长越重 ......