Results of screw epiphysiodesis for the treatment of limb length discrepancy and angular deformity
Results of screw epiphysiodesis for the treatment of limb length discrepancy and angular deformity
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DOI：
10.1097/bpo.0b013e318093f4f4
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发表时间：
2007-09-01
影响因子：
1.7
通讯作者：
Sanders, James O.
中科院分区：
文献类型：
--
作者：
Khoury, Joseph G.;Tavares, Joao O.;Sanders, James O.
本研究的目的是评价螺丝钉固定技术的有效性、可预测性和可逆转性。我们回顾了我们的第一批60例患者(105个植体)采用经皮螺钉骨盆固定术或半骨盆固定术的病例。所有病例均随访唇至成熟期或在完全矫正后仍有生长的情况下取出螺丝钉。共有30名患者接受了肢体长度不等的手术。将最终的不等性与预测的骨盆融合效应进行比较。共30例(66个)患者接受了螺丝钉半骨盆固定术，以矫正角度畸形。计算每个月的矫正度，分析手术的可逆性，评估并发症。在长度组，治疗结束时，股骨的最终肢体长度差平均为0.15 cm(SD，+/-0.37 cm)，与用乘子法预测的骨盆固定效果相差不大。在胫骨，这一差异为0.05 cm(SD，+/-0.57 cm)。在角度组，股骨远端平均矫正6.91度(SD，+/-3.75度)或0.75度/月(SD，+/-0.45度/月)。胫骨近端平均矫正3.88度(SD，+/-3.57度)或0.37度(SD，+/-0.34度/月)。在所有13例在角度矫正时取出螺钉并保留显著生长的病例中，生长都恢复了。并发症较小，与螺钉放置不正确或硬件轻微刺激有关。经皮椎弓根螺钉成形术是一种可靠的、微创的方法，在长度和角度矫正方面都有可靠的结果，发病率最低，并发症发生率可接受。
The purpose of this Study was to evaluate the technique of screw epiphysiodesis for effectiveness, predictability, and reversibility. We reviewed the cases of our first 60 patients (105 physes) treated with percutaneous screw epiphysiodesis or hemiepiphysiodesis. All cases were followed LIP to maturity or screw removal if growth remained after full correction. A total of 30 patients underwent the procedure for limb length inequality. Final inequality was compared with the predicted epiphysiodesis effect. A total of 30 patients (66 physes) underwent screw hemiepiphysiodesis for the correction of angular deformity. The degree of correction per month was calculated, the reversibility of the procedure was analyzed, and complications were evaluated. In the length group, at the end of treatment, the final limb length difference in the femur averaged 0.15 cm (SD, +/- 0.37 cm) from the epiphysiodesis effect predicted by using the multiplier method. In the tibia, this difference was 0.05 cm (SD, +/- 0.57 cm). In the angular group, the average correction in the distal femur was 6.91 degrees (SD, +/- 3.75 degrees) or 0.75 degrees per month (SD, +/- 0.45 degrees per month). In the proximal tibia, the average correction was 3.88 degrees (SD, +/- 3.57 degrees) or 0.37 degrees per month (SD, +/- 0.34 degrees per month). In all 13 cases where the screws were removed at the time of angular correction with significant growth remaining, growth resumed. Complications were minor and were related to incorrect placement of screws or minor hardware irritation. Percutancous screw epiphysiodesis is a reliable, minimally invasive method with reliable results in both length and angular correction, with minimal morbidity, and with an acceptable complication rate.