| Ilizarov外固定架治疗痉挛型脑瘫屈膝畸形 |
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Received:October 30, 2008
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| 作者 | Author | 单位 | Unit | E-Mail |
| 胡炜 |
HU Wei |
北京中医药大学东直门医院骨科，北京 100700 |
Department of Orthopaedics,the Dongzhimen Hospital Affiliated to Beijing University of TCM,Beijing 100700,China |
realhuwei@163.com |
| 许世刚 |
XU Shi-gang |
北京中医药大学东直门医院骨科，北京 100700 |
Department of Orthopaedics,the Dongzhimen Hospital Affiliated to Beijing University of TCM,Beijing 100700,China |
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| 曹旭 |
CAO Xu |
北京中医药大学东直门医院骨科，北京 100700 |
Department of Orthopaedics,the Dongzhimen Hospital Affiliated to Beijing University of TCM,Beijing 100700,China |
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| 张鹏 |
ZHANG Peng |
北京中医药大学东直门医院骨科，北京 100700 |
Department of Orthopaedics,the Dongzhimen Hospital Affiliated to Beijing University of TCM,Beijing 100700,China |
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| 徐林 |
XU Lin |
北京中医药大学东直门医院骨科，北京 100700 |
Department of Orthopaedics,the Dongzhimen Hospital Affiliated to Beijing University of TCM,Beijing 100700,China |
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| 期刊信息：《中国骨伤》2008年21卷，第12期，第922-924页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨应用软组织矫形加用Ilizarov外固定架矫治痉挛型脑瘫屈膝畸形的方法和疗效。
方法：依据Ilizarov张力-应力法则及其应用技术，按个体化要求，安装Ilizarov外固定架， 在外固定架屈侧设置2个铰链关节便于撑开，伸侧设置1个铰链关节便于加压。术后3～5 d,待患者腿部疼痛、麻木感减轻后开始屈侧撑开，伸侧加压，每日屈侧延长2 mm左右。定期检查克氏针的张力，以免固定松动。每2周摄X线片复查，根据目测观察膝关节矫正角度及X线表现及时修正延长、矫形方案。患者3～6周后膝关节角度就可完全矫正，在过伸10°位置维持3周，即可拆除Ilizarov外固定架，活动膝关节，然后佩戴下肢伸直位支具行走2～3个月。2例因术前合并股骨下段前弓畸形，Ⅱ期实施股骨髁上截骨术矫正。
结果：21例36个膝关节，术前屈膝畸形平均(80.61±25.51)°，矫正后屈曲角度平均(8.91±2.39)°。21例， 36个关节平均随访5个月，其中32个关节维持牵伸术后的效果，4个关节屈膝畸形部分复发，平均(9.32±7.33)°。
结论：正确使用Ilizarov技术矫治痉挛型脑瘫屈膝畸形，疗效满意，并发症少，是一种微创、安全、有效的治疗方法。 |
| [关键词]:膝关节 畸形 脑性瘫痪 外固定器 外科手术,微创性 |
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| Ilizarov external fixator for the treatment of severe genuflex deformity in spastic cerebral palsy patients |
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Abstract:
Objective: To explore the application and efficacy of Ilizarov external fixator in the treatment of severe genuflex deformity in spastic cerebral palsy patients.
Methods: The individualized Ilizarov external fixtor was designed to have two hinges posteriorly and one hinges anteriorly based on the tension-stress law. Distraction posteriorly and simutaneously compression anteriorly started 3 to 5 days after surgery. Extension on the flexion side was 2 mm every day. Check toe movement,wound and wire tension everyday. The deformity were corrected in 3 to 6 weeks. Then the fixator were kept in overextension of about 10° for about 3 weeks before the Ilizarov external fixator were removed. The patients were encourged to start knee rehabilitation program and discharged. And a long leg brace was prescribed to wear while walking for 2 to 3 months.
Results: The average genuflex deformity was(80.61±25.51)° preoperatively and(8.91±2.39)° postoperatively. The patients were followed up for 5 months,21 of which got an excellent results,4 joints had recurrence of the deformity with an average of(9.32±7.33)°。
Conclusion: The proper use of Ilizarov technique in the treatment of severe genuflex deformity in spastic cerebral palsy patients could get satisfactory results with few complications. |
| KEYWORDS:Knee joint Abnormalities Cerebral palsy External fixators Surgical procedures,minimally invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 胡炜,许世刚,曹旭,张鹏,徐林.Ilizarov外固定架治疗痉挛型脑瘫屈膝畸形[J].中国骨伤,2008,21(12):922~924 |
| 英文格式: | HU Wei,XU Shi-gang,CAO Xu,ZHANG Peng,XU Lin.Ilizarov external fixator for the treatment of severe genuflex deformity in spastic cerebral palsy patients[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(12):922~924 |
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