[在我们中心使用Precise®髓内钉进行股骨延长的第一个病例系列]。

Acta ortopedica mexicana Pub Date : 2022-03-01
V Marquina, B Novoa, P Badía, P Jover, F Jara, L Hernández
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引用次数: 0

摘要

简介:在常规临床实践中,髓内钉股骨延长是治疗严重下肢发育不良的手术选择之一。材料和方法:对5例平均年龄15.4岁的患者进行回顾性描述性研究,这些患者采用Precice®髓内钉进行股骨延长术。所有病例的病因均为特发性。测量术前和术后明确的理论延长或不对称,以及延长准确性,牵张率和指数(分别为mm/day和days/cm)和巩固指数(days/cm)。所有病例均发现术中及术后并发症。结果:平均随访21个月(12-42),无随访损失。手术过程的平均持续时间为126分钟(105-160)。术前理论不对称为38±2.7 mm。最终平均延长41±7.5 mm。平均正确率为108%(91 ~ 125),牵张率为0.9±0.4 mm/d。牵张率为13.9±5.1天/cm,实变率为26.6±9.1天/cm。所有患者的骨巩固时间平均为113±58天。并发症方面,共发现4例轻微的肌肉并发症。结论:Precice®髓内钉是治疗严重股骨短缩的良好选择,临床和影像学效果良好,并发症和内钉失败率低。
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[First case series of femoral lengthening using a Precice® intramedullary nail in our center].

Introduction: femoral lengthening using an intramedullary nail is one of the surgical options in the treatment of severe lower limb dysmetria in routine clinical practice.

Material and methods: a retrospective descriptive study was carried out on a series of five patients with a mean age of 15.4 years, who underwent femoral lengthening surgery using a Precice® intramedullary nail. The etiology in all cases was idiopathic. Preoperative and definitive postoperative theoretical lengthening or dysmetry was measured, as well as lengthening accuracy, distraction rate and index (mm/day and days/cm, respectively) and consolidation index (days/cm). Intraoperative and postoperative complications were identified in all cases.

Results: mean follow-up was 21 months (12-42), with no loss to follow-up. The mean duration of the surgical procedure was 126 minutes (105-160). The preoperative theoretical dysmetry was 38 ± 2.7 mm. The final mean lengthening was 41 ± 7.5 mm. The mean accuracy was 108% (91-125) and the distraction rate was 0.9 ± 0.4 mm/day. The distraction rate was 13.9 ± 5.1 days/cm and the consolidation rate was 26.6 ± 9.1 days/cm. Bone consolidation was observed in all patients with a mean of 113 ± 58 days. Regarding complications, a total of four minor muscular complications were found.

Conclusion: the Precice® intramedullary nail is a good treatment option for cases of severe femoral shortening, providing good clinical and radiological results with a low rate of complications and implant failure.

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