|关键词||骨软骨瘤 膝外翻 骺阻滞|
|其他题名||8-plate hemiepiphysiodesis for genu valgum deformity correction in children with hereditary multiple exostoses|
Objective To discuss the surgical time, technique and prognosis to treat genu valgum deformity with hereditary multiple exostoses in children by 8-plate.
Methods Studying clinical data from genu valgum deformity with multiple exostoses treated by 8-plate between July 2009 to July 2014. There were 11 boys and 4 girls, ranging in age from 4.3 years to 13.5 years, with an average age of 10.2 years, involving 6 left, 5 right and 4 bilateral knees. Angular deformity change was evaluated by the anatomical lateral distal femoral angle, medial proximal tibial angle and mechanical axis deviation.
Result Hemiepiphysiodesis included 15 femurs and 14 tibias. The follow-up period was ranged from 9 to 49 months, with a meaning of 26.5 months. Periods from stapling to staple removal ranged from 5 to 31 months, with a meaning of 15.2 months. Amount of angular correction by 8-plate at the distal femur was 5.1~11.4º（averaged 7.5º）, and at the proximal tibia, 2.3~14.5º（averaged 7.0º）. Correction velocity at the 14 femurs was 0.3~1.1º/M（averaged 0.6°/M）, and at the 12 tibias, was 0.2~1.0º/M（averaged 0.5°/M）. Seventeen legs had mechanical axes in zone +1 or -1, one leg in zone +3, one leg in zone -2, and the total good rate was 89.5%. There were 22 femurs or tibias whose follow-up period was more than 6 months after 8-plate removal. Eleven of them rebounded at latest follow-up.
Conclusion The technique of 8-plate hemiepiphysiodesis is minimally invasive and effective for genu valgum deformity with hereditary multiple exostoses in children. Patients should be treated in time, rational therapeutic regimen should be made, and close monitor should be mandatory until skeletal maturity.
|张骥. 8字板矫正儿童多发骨软骨瘤病的膝外翻畸形[D]. 北京大学第四临床医学院. 北京大学,2016.|
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