638例双下肢延长术(增高)临床报告.docx

638例双下肢延长术〔增高〕临床报告

夏和桃彭爱民韩义连秦泗河石文元

【摘要】目的为低于身高均值2个标准差以下的成人矮身材、侏儒症，有增高愿望的志愿者实施双下肢延长术，满足他们对合理身高的追求。方法：依据Ilizarov(骨外固定)提出的牵拉成骨技术〔DistractionosteogenesisDO〕，应用骨外固定延长器系统[〔1]lockingIntramedullarynailwithExternalFixatorforlimbsLengtheningIEFL〕与锁髓内钉，为638例矮身材和侏儒症实施双下肢延长术。手术安放带锁髓内钉与外固定延长器，术后第8天始，以0.5-1mm/d的速度延长，到达所需长度后，插入髓内钉的远端锁钉，撤除延长器。在延长期和康复期，通过标准有序的功能训练，增加机械和生理应力刺激，促进骨和肢体功能的恢复。结果：本组病例随访时间3年至9年，平均5年，增加身高8～26cm，平均9.6cm。结果，优为99.53%，良为0.31%，可为0.16%。发生可逆的并发症48例〔56个肢体〕，7.52%，其中轻度5.96%，中度1.09%，重度0.47%，至今尚未觉察不行逆并发症

〔后遗症〕。结论IEFL技术，是在Ilizarov骨延长技术根底上的创与完善，是大幅度〔＞15%〕双下肢延长的一种安全牢靠、高效方法，延长中还可同期矫治下肢畸形。

【关键词】骨外固定ILIZAROV 增高矮身材侏儒症双下肢延长

Internal-externalfixationforlowerlimbsinthetreatmentofshortstatures

XIAHe-tao*,PENGAi-min,QINSi-he,HanYi-lian,ShiWen-yuan.*Beijinginstituteofexternalskeletalfixationtechnology,Beijing1000039

【Abstract】AbjectiveThepurposeofthesurgicaloperationistoincreasetheheightofadultpatientswhoare2SDbelowtheaverageheightsoastosatisfytheirneedforanormalbodyheight,tobuiltuptheirconfidenceinsocialactivitiesandtoincreasetheirchanceofsuccessinmarriageandjobhunting.MethodsBasedonIlizarov’sTension-StresstheoryandhistechnicalprinciplesaswellasthephysicalstructureofChinesepopulation,theoperationsareperformedon638adultsusingourself-designed,self-madetibialintramedullarylockingnailsystemanddynamicsynchronouslimblengtheningdevice.Thelimbswerelengthenedataspeedof0.5-1mm/dstartingfromthe8thdayaftertheoperation.Whentheidealbodyheightwasacquired,thedistallockingscrewswerelockedandlengtheningdeviceremoved.

Inordertoprovidethestressstimulusneededtomineralizethebone,proper

weight-bearingexercisesweredoneduringtheprocessoflimblengtheningandrecoveryuntilthenewlygrownboneiscompletelymineralized.ResultsThefollow-upcasesstudyofthegrouplasted2.5-7.5y