638例双下肢延长术（增高） - 北京骨外固定技术研究所.doc

638例双下肢延长术（增高）临床报告 夏和桃 彭爱民 韩义连 秦泗河 石文元 【摘要】 目的 为低于身高均值2个标准差以下的成人矮身材、侏儒症，、有增高愿望的志愿者实施双下肢延长术，满足他们对合理身高的追求，以增加自信和融于社会（求职、婚姻等）的机遇。方法：根据Ilizarov提出的牵拉成骨技术（Distraction osteogenesis DO），应用自行研制的带锁髓内钉与外固定延长器系统[1]（locking Intramedullary nail with External Fixator for limbs Lengthening IEFL），为638例矮身材和侏儒症实施双下肢延长术。手术安放带锁髓内钉与外固定延长器，术后第8天始，以0.5-1mm/d的速度延长，达到所需长度后，插入髓内钉的远端锁钉，拆除延长器。在延长期和康复期，通过规范有序的功能训练，增加机械和生理应力刺激，促进新骨和肢体功能的恢复。结果：本组病例随访时间3年至9年，平均5年，增加身高8～26cm，平均9.6cm。结果，优为99.53%，良为0.31%，可为0.16%。发生可逆的并发症48例（56个肢体），7.52%，其中轻度5.96%，中度1.09%，重度0.47%，至今尚未发现不可逆并发症（后遗症）。结论 IEFL技术，是在Ilizarov骨延长技术基础上的创新与完善，是大幅度（＞15%）双下肢延长的一种安全可靠、高效方法，延长中还可同期矫治下肢畸形。 【关键词】矮身材 侏儒症 双下肢延长 带锁髓内钉 外固定延长器 Internal-external fixation for lower limbs in the treatment of short statures ? XIA He-tao*, PENG Ai-min, QIN Si-he, Han Yi-lian, Shi Wen-yuan.*Beijing institute of external skeletal fixation technology, Beijing 1000039 【Abstract】 Abjective ?The purpose of the surgical operation is to increase the height of adult patients who are 2SD below the average height so as to satisfy their need for a normal body height, to built up their confidence in social activities and to increase their chance of success in marriage and job hunting. Methods ?Based on Ilizarov’s Tension-Stress theory and his technical principles as well as the physical structure of Chinese population, the operations are performed on 638 adults using our self-designed, self-made tibial?intramedullary locking nail system and dynamic synchronous limb lengthening device. The limbs were lengthened at a speed of 0.5-1mm/d starting from the 8th day after the operation. When the ideal body height was acquired, the distal locking screws were locked and lengthening device removed. In order to provide the stress stimulus needed to mineralize the bone, proper weight-bearing exercises were done during the process of limb lengthening and recovery until the newly grown bone is completely mineralized. Results ?The follow-up cases study of the group lasted 2.5-7.5 y