目的:探讨应用Ilizarov技术在旋转中心穹顶状截骨治疗青少年股骨远端外翻畸形的疗效。方法:采用回顾性研究分析2016年1月至2020年10月收治并获得完整随访的 11例股骨远端外翻畸形患者的临床资料，其中男7例，女4例;右侧6例，左侧5例;年龄10～14岁。在股骨远端畸形处找出成角旋转中心(center of roration of angula-tion，CORA)，以CORA为中点，行穹顶状截骨，根据Ilizarov外固定穿针原则安装环形外固定架，截断股骨远端，即时矫正股骨远端目测下外翻畸形，外固定架固定维持。术后根据双下肢负重全长正侧位X线片提示的下肢力线及长度结果，矫正残余畸形及短缩。结果:11例均得到随访，时间13～25个月，带架时间12～17周。末次随访拍摄双下肢负重全长正侧位X线片测量11例双下肢长度均等长，畸形均矫正。采用美国特种外科医院(Hospital Special Surgery，HSS)评分评价膝关节功能，均为优。结论:应用Ilizarov技术在旋转中心穹顶状截骨治疗青少年股骨远端外翻畸形，术中即时矫正目测下股骨外翻畸形，术后根据双下肢负重正侧位片提示的下肢力线及短缩程度，动态调整矫正残余畸形及短缩，损伤小，恢复快。
Ilizarov technique combined with center of rotation dome-shaped osteotomy for the treatment of juvenile distal femoral valgus deformity
Objective To investigate the effect of Ilizarov technique combined with rotational center dome-shaped osteoto-my in the treatment of juvenile distal femoral valgus deformity.Methods A retrospective study was conducted to analyze the clinical data of 11 patients with valgus deformity of the distal femur who had been admitted and followed up completely from January 2016 to October 2020.There were 7 males and 4 females.The 6 patients were on the right side and 5 patients were on the left side.The age ranged from 10 to 14 years old.The center of roration of angulation(CORA)was identified at the distal femur deformity,and dome-shaped osteotomy was performed with the CORA as the midpoint.The annular external fixator was installed according to the needle threading principle of Ilizarov external fixation,and the distal femur was cut off.The valgus deformity under visual inspection of the distal femur was corrected immediately,and the external fixator was fixed and main-tained.The residual deformity and shortening were corrected according to the force line and length of the lower limbs suggested by the weight-bearing full-length anteroposterior and lateral X-rays of both lower limbs.Results All 11 patients were followed up for 13 to 25 months.The time of wearing external fixator was 12 to 17 weeks.In the last follow-up,both lower limbs were measured by the weight-bearing full-length anteroposterior and lateral X-rays,and the length of both lower limbs of 11 patients were equal,and the deformities were corrected.The score of hospital for special surgery(HSS)was used to evaluate the knee function,all of which were excellent.Conclusion The Ilizarov technique was applied in the treatment of distal femoral valgus deformity in adolescents using a rotating central dome-shaped osteotomy.Visual femoral valgus deformity was corrected imme-diately during the operation.After the operation,residual deformities and shortening were dynamically adjusted and corrected according to the force line and shortening degree of lower extremities indicated by the weight-bearing anteroposterior and lateral radiographs of both lower limbs,with minimal damage and fast recovery.
Femoral deformityDeformity angulation center of rotationDome-shaped osteotomyIlizarov technique
万方数据
维普
