骨痂延长治疗儿童股骨化脓性骨髓炎后骨缺损及肢体短缩.pdfVIP

1O6 ， 岛 2 (1)http：／一／csumea．org；http：／x／byx一-net 骨痂延长治疗儿童股骨化脓性骨髓炎后骨缺损及肢体短缩 刘傥 ，张湘生，黎志宏，黄辉 (中南大学湘雅二医院骨科 ，长沙 410011) 【摘要】目的：探讨外固定支架行骨痂延长治疗儿童股骨化脓性骨髓炎后骨缺损及肢体短缩的疗效。方法：采用 外固定支架对 19例儿童股骨化脓性骨髓炎后骨缺损及肢体短缩的患者行骨痂延长术，术前患肢平均骨缺损长度 1_3 cm ，患肢平均短缩4．8cm。结果：所有病例随访21～82个月，骨不连接处全部愈合，骨延长区骨生长满意。骨延长4．5～8．0 em，平均外固定指数39．7d／cm。依据Paley的评定标准进行骨愈合评定，优为 14例，良为5例；功能评定优为 11例， 良为8例。结论：外固定支架行骨痂延长是治疗儿童股骨化脓性骨髓炎后骨缺损及肢体短缩的可靠方法。 【关键词 】外固定支架；骨缺损；肢体短缩；骨痂延长 DOI：10．3969／j．issn．1672-7347．2012．O1．019 Callusdistractioninbonedefectandlegshorteningof femurafterosteomyelitis LIU Tang，ZHANGXiangshengLIZhihong，HUANGHui (DepartmentofOrthopedics,SecondXiangyaHospital,CentralSouthUniversity,Changsha410011JChina) Objective：Toexploretheefficacyofcallusdistractionperformedbyexaternalfixtorinthe reconstructionofbonedefectandlegshorteningoffemurafterosteomyelitis． Methods：Nineteenchildpatientswithbonedefectandlegshorteningafterostemomyelitiswere treatedbycallusdistractionwithexternalfixatonThemeanlengthofthebonedefectwas1．3cm． Th emeanleg—lengthdiscrepancywas4．8cm． Results：Allpatientswerefollowedupfor21—82months．Thebonelengtheningareagrewwell，the lengthofcallusdistractionwas4．5—8．0cm，andthemeanradiographicconsolidationindexwas39．7 d／cm．AccordingtothePaleyscriteriajthehealingeffectof14caseswasexcellent,andthatofhte rest5caseswasgood．Thefunctionalrecoveryofl1caseswasexcellentJandthatoftherest8cases wasgood． Conclusion：Callusdistractionisareliablemethodinthereconstructionofbonedefectandleg shorteningcausedbyoste