文章简介

出版社:Clinics in Orthopedic Surgery

作   者:Kyungjei Woo, Yeong Seok Lee, Won-Yung Lee, Jong Sup Shim

编   号:10.4055/cios.2016.8.1.92.

年   份:2016    点击量:802

文章摘要

Background:

Percutaneous lateral hemiepiphysiodesis of the lower extremity is a simple and excellent method to correct the angular and length problems cosmetically. However, the efficacy of percutaneous lateral hemiepiphysiodesis is not well established in the literature. The purpose of this study was to evaluate the efficacy of percutaneous lateral hemiepiphysiodesis for angular corrections in adolescent idiopathic genu varum patients with proximal tibia vara and identify the factors affecting the amount of deformity correction of the lower limb in the coronal plane.

背景:

经皮侧向半骺骨干固定术是矫正下肢角度和长度美观问题的简单而有效的方法。然而,文献中经皮侧向半骺骨干固定术的疗效尚未健全。本研究旨在评估经皮侧向半骺骨干固定术矫正伴胫骨近端内翻的青少年特发性膝内翻患者成角的疗效,并查明影响下肢冠状面畸形矫正的因素。

 

Methods:

We retrospectively reviewed 20 patients (40 lower limbs) who had percutaneous lateral hemiepiphysiodesis on the proximal lateral tibia between 1997 and 2010. Radiographic evaluations were made using the hip-knee-ankle angle and the length of the tibia. Furthermore, the intercondylar distance was evaluated at the level of the knee joint. Preoperative factors (gender, age, body mass index, intercondylar distance, preoperative hip-knee-ankle angle, remaining growth of tibia, and calculated correctable angle) were analyzed, as well as their correlation with the degree of the actual correction angle.

方法:

我们回顾总结了19972010年间20例(40条下肢)在胫骨近端外侧进行经皮侧向半骺骨干固定术治疗的患者。对髋膝踝关节角度和胫骨长度进行影像学评估。此外,以膝关节为标准评估髁间距。分析了术前因素(性别、年龄、体重指数、髁间距、术前髋膝踝角、胫骨剩余生长及计算的矫正角度),以及这些因素对成角实际矫正程度的影响。

 

Results:

The amount of coronal deformity of the lower limb was improved from its preoperative state. The median average of hip-knee-ankle angle improved from 8.0° (interquartile range [IQR], 7.0° to 10.0°) preoperatively to 3.0° (IQR, 2.5° to 4.0°) at the final follow-up ( p < 0.001). The median percent ratio of the angular correction was 60% (IQR, 50% to 71.3%). The correlation coefficients were -0.537, 0.832, 0.791, and 0.685 for the bone age, preoperative hip-knee-ankle angle, the remaining growth of tibia, and calculated correctable angle, respectively.

结果:

下肢冠状面畸形较术前有所改善。在最近一次随访中,患者髋膝踝角的平均中位数由术前的(四分位距[IQR]7°~10°)下降至IQR2.5°~4°)(P0.001)。角度矫正的中位数比值为60%IQR50%~71.3%)。骨龄、术前髋膝踝角、胫骨剩余增长和计算出的矫正角度的相关系数分别为-0.5370.8320.7910.685

 

Conclusions:

Despite the excellent cosmetic outcome of percutaneous lateral hemiepiphysiodesis on the proximal lateral tibia in adolescent idiopathic genu varum, the effect was limited in most cases. For optimum results, surgery a few months earlier is recommended, rather than at the calculated operation time.

结论:

尽管经皮侧向半骺骨干固定术矫正青少年胫骨近端外侧特发性膝内翻的整形效果极好,但在多数病例中疗效仍受限。为获得最佳疗效,建议提前几个月进行手术,而不是在预算的手术时间进行。

 

 

Midcool医库软件 王露黔 编译

原文来自:Clinics in Orthopedic Surgery