Xu Ping,Ning Bo,Chen Yufan,et al.Efficiency of temporary hemiepiphysiodesis with eight-plate in children with lower limb discrepancy[J].Journal of Clinical Pediatric Surgery,2020,19(01):59-62.[doi:10.3969/j.issn.1671-6353.2020.01.012]
8字钢板临时阻滞在儿童下肢不等长中的应用效果分析
- Title:
- Efficiency of temporary hemiepiphysiodesis with eight-plate in children with lower limb discrepancy
- Keywords:
- Lower Limb Discrepancy; Eight-Plate; Epiphysiodesis; Child
- 分类号:
- R726.8;R681.4
- 摘要:
- 目的 探讨8字钢板临时骨骺阻滞在儿童下肢不等长（lower limb discrepancy，LDD）治疗中的有效性及可行性。方法 回顾性分析自2011年11月至2017年1月复旦大学附属儿科医院小儿骨科收治的14例LLD患儿临床资料，通过双下肢全长站立位X线片测量术前、术后股骨、胫骨长度变化，通过生长曲线分析使用8字钢板临时阻滞术后肢体不等长的改善情况，计算其在骨骺阻滞中的作用和效率。结果 对14例患儿共17个部位（股骨远端及胫骨近端）行内外侧联合8字钢板阻滞，平均随访时间（29.4±8.53）个月，阻滞长度中位数为18.8 mm（5~40 mm），平均阻滞率为（59.5±18.0）%。本组病例均未出现骨骺早闭及骺板损伤的情况。此外通过分析发现，阻滞部位（胫骨近端或股骨远端）、年龄、性别、侧别对阻滞率没有影响（P>0.05），而骨骺阻滞时间与阻滞率呈正相关（r=0.438，P<0.05）。结论 8字钢板在LLD中的临时性骨骺阻滞为非完全性阻滞，可以作为LLD病人治疗的一种选择，但是其矫形能力有限，术前应充分评估患儿的生长潜力。此外，术后密切随访也是取得理想治疗效果的关键。
- Abstract:
- Objective To explore the efficacy and feasibility of temporary hemiepiphysiodesis with eight-plate for children with lower limb discrepancy (LLD).Methods A retrospective study was conducted for LLD children from November 2011 to January 2017.Radiological assessments were performed by standing full-length X-ray.By analyzing the change of the length of bones after temporary hemiepiphysiodesis with eight-plate,retarding efficiency was calculated according to the growth curve of eight-plate.Results A total of 14 patients (17 physes) were included.The average follow-up period was 29.4(29.4±8.53) months,the average blocking length was 18.8(5-40) mm and the average blocking rate was 59.5% (0.595±0.18).No epiphyseal closure or epiphyseal plate injury occurred.No statistical differences existed in site (proximal tibia or distal femur),age,gender or sideness.Blocking rate was positively correlated with blocking time (r=0.438,P<0.05).Conclusion Temporary epiphyseal blocking of 8-plate in LLD is incomplete and it may be an alternative treatment for LLD children.However,for its limited correction efficacy,growth potential should be fully evaluated.And close postoperative follow-up is also vital for achieving an excellent outcome.
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备注/Memo
收稿日期:2019-02-02。
通讯作者:王达辉,Email:wangdahui@fudan.edu.cn