IR@PKUHSC  > 北京大学第四临床医学院
学科主题外科学
8字板矫正儿童多发骨软骨瘤病的膝外翻畸形
张骥
2016-05-24
导师王满宜
专业外科学
授予单位北京大学
授予地点北京大学第四临床医学院
学位博士
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
分类号R738.3
摘要

目的  探讨8字钢板半侧骺阻滞技术矫正儿童多发性骨软骨瘤病引起的膝外翻畸形的手术时机、方案和短期疗效。

方法  回顾性分析2009年7月至2014年7月采用8字钢板治疗的骨软骨瘤病膝外翻畸形的病例资料。男11例,女4例;年龄4.3~13.5岁(平均10.2岁);左膝6例,右膝5例,双膝4例。采用股骨远端解剖轴外侧角、胫骨近端内侧角和下肢机械轴偏离度来评价畸形并指导治疗。

结果  半侧骺阻滞术包括15例股骨和14例胫骨,术后随访时间9~49个月(平均26.5个月)。带板时间5~31个月(平均15.2个月),取板时股骨外翻角度改善5.1~11.4º(平均7.5º),胫骨外翻角度改善2.3~14.5º(平均7.0º)。14例股骨矫正速率0.3~1.1º/月(平均0.6º/月),12例胫骨矫正速率0.2~1.0º/月(平均0.5º/月)。下肢机械轴17例位于-1~+1区,1例位于+3区,1例位于-2区,优良率达89.5%。22例骨取板后随诊时间超过6个月,11例外翻角度出现反弹。

结论  8字钢板半侧骺阻滞技术治疗骨软骨瘤病患儿的膝外翻畸形创伤小,并发症少。只要能及时治疗,合理设计方案,术后密切随诊,均可获得满意的结果。

英文摘要

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.

语种中文
相关网址查看原文
文献类型学位论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/124759
Collection北京大学第四临床医学院
作者单位北京大学第四临床医学院
Recommended Citation
GB/T 7714
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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