What’s new in pediatric lower limb reconstruction?

Christof Radler, Peter Calder, M. Eidelman, Joachim Horn, S. Kold, Micha Langendörfer, H. Manner, I. Sedki, B. Vogt
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Abstract

The last years brought many advances relevant to lower limb reconstruction. It feels like guided growth has been looked at from every angle, and still there are new emerging concepts like rotational guided growth waiting to be validated. New hexapod external devices are more accurate and easier to use, and new unilateral fixators allow for more versatile and stable fixation and lengthening. Intramedullary nail lengthening has found its place as a standard procedure for various diagnoses in children and young adults. First results of new and exciting approaches like extramedullary implantable nail lengthening and lengthening plates have been reported. Pharmaceutical treatment has changed the course of certain diseases and must be integrated and considered when making a reconstructive treatment plan. As reconstructive surgery is rapidly advancing so are the technical options for prosthetic fitting, which makes it difficult for caregivers as well as for parents to make the decision between reconstruction and amputation surgery for the most severe cases of congenital deficiencies. This review is highlighting new developments of lower limb reconstruction and is reviewing the current literature.
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小儿下肢重建有哪些新进展?
过去几年,下肢重建领域取得了许多进展。人们似乎已经从各个角度对引导生长进行了研究,但仍有一些新出现的概念(如旋转引导生长)有待验证。新型六爪外固定器更精确、更易用,新型单侧固定器可实现更多样、更稳定的固定和延长。髓内钉延长术已成为儿童和青少年各种诊断的标准手术。髓外植入式钢钉延长术和钢板延长术等令人振奋的新方法已初见成效。药物治疗已经改变了某些疾病的病程,在制定整形治疗计划时必须加以综合考虑。随着重建手术的快速发展,假肢安装的技术选择也在不断增加,这使得护理人员和家长很难在重建手术和截肢手术之间做出抉择。本综述将重点介绍下肢重建的新进展,并对现有文献进行回顾。
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