中国修复重建外科杂志

中国修复重建外科杂志

应用骨外固定技术矫正四肢畸形 8 113 例数据分析

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目的 统计分析秦泗河矫形外科团队 30 年间治疗四肢畸形所应用的骨外固定器械(包括 Ilizarov 器械)数据,探讨现代骨外固定技术矫正四肢畸形的应用指征、个体化器械构型选择策略等。 方法 依据秦泗河矫形外科团队肢体畸形矫形手术病例数据库,回顾性统计分析 1988 年 1 月—2017 年 12 月外固定器使用情况,分别从外固定器总体使用情况,不同性别、不同手术时间段、不同年龄段、不同部位及不同病种外固定器应用情况等方面,进行外固定器总体使用情况及不同外固定器构成进行统计、分析。 结果 8 113 例患者手术中应用了骨外固定器,其中双下肢手术同时应用者 69 例,共应用 8 182 套外固定器。其中组合式外固定器 4 725 套(57.74%)、Ilizarov 环式外固定器 3 388 套(41.41%)、单臂外固定器 64 套(其中包括 Orthofix 器械)(0.78%)、Taylor 空间外固定器 5 套(0.06%)。男 4 487 例(55.31%),女 3 626 例(44.69%)。从不同时间段分析显示,外固定器使用数量逐年增加,2000 年后应用数量突破性增多。患者年龄以 11~30 岁为主,其中 21~25 岁使用最多,达 1 819 套(22.23%)。外固定器应用部位几乎涵盖了四肢所有区域,其中踝足趾部位最多,达 4 664 套(57.00%);上肢最少,共 152 套(1.86%)。8 113 例中治疗的疾病涵盖了十余个学科、超过 150 个病种,其中使用外固定器治疗最多的前 5 位疾病为:脊髓灰质炎后遗症、脑性瘫痪、脊柱裂后遗下肢畸形、创伤后遗症、先天性马蹄内翻足。 结论Ilizarov 技术已广泛应用于血管、淋巴、神经、皮肤、内分泌等疾病导致的肢体畸形、残疾以及骨科疑难杂症,其手术适应证远超出了骨科学范围。国产外固定器及其安装工具基本能满足各种治疗的要求。骨外固定技术已全面进入了应力控制下的牵拉组织再生,自然修复组织创伤与残缺、重建肢体功能的新时代。

Objective To analyze the data of external fixation instruments (including Ilizarov instruments) used by QIN Sihe orthopaedic surgical team in the treatment of limb deformities in the past 30 years, and to explore the indications for the application of modern external fixation techniques in the correction of limb deformities and individual device configuration selection strategy. Methods According to QIN Sihe orthopaedic surgical team, the use of external fixator between January 1988 and December 2017 was analyzed retrospectively. The total use of external fixation and the proportion of different external fixators were analyzed in gender, different operation time, different age, different parts, and different diseases. Results External fixators were used in 8 113 patients, 69 of them were used simultaneously in both lower extremity surgery, so 8 182 external fixators were used. Among them, there were 4 725 (57.74%) combined external fixators, 3 388 (41.41%) Ilizarov circle fixators, 64 (0.78%) single arm external fixators (including Orthofix), 5 (0.06%) Taylor space external fixators. There were 4 487 males (55.31%) and 3 626 females (44.69%). According to the analysis of different time periods, the number of external fixators increased year by year, and the number of applications increased after 2000. The main age of the patients was 11-30 years old, of which 1 819 sets (22.23%) were used at the age of 21-25 years. The use of the external fixator covered almost all parts of the limbs, with the ankle and toe areas being the most common, reaching 4 664 sets (57.00%), and the upper extremities the least, with 152 sets (1.86%). The 8 113 cases covered more than a dozen disciplines and more than 150 kinds of diseases. The top 5 diseases were poliomyelitis sequelae, cerebral palsy, deformity of lower extremity after spina bifida, traumatic sequelae, and congenital equinovarus foot. Conclusion Ilizarov technique has been widely used in extremity deformity, disability, and complicated orthopedic diseases caused by vascular, lymphoid, nerve, skin, endocrine, and other diseases. The indication of operation is far beyond the scope of orthopedics. The domestic external fixator and its mounting tools can basically meet the requirements of various treatments. The technique of external fixation has entered a new era of tension tissue regeneration under stress control, natural repair of tissue trauma and deformity, and reconstruction of limb function.

关键词: 骨外固定; 四肢畸形; 大数据; 统计

Key words: Bone external fixation; limb deformity; big data; statistics

引用本文: 秦泗河, 郭保逢, 焦绍锋, 臧建成, 张力, 王一岚, 郑学建, 石磊, 秦绪磊. 应用骨外固定技术矫正四肢畸形 8 113 例数据分析. 中国修复重建外科杂志, 2018, 32(10): 1241-1248. doi: 10.7507/1002-1892.201807055 复制

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1. 秦泗河, 郭保逢, 郑学建, 等. 国产骨外固定器治疗四肢残缺畸形 7 289 例应用报告. 中华外科杂志, 2017, 55(9): 678-683.
2. Birch JG. A brief history of limb lengthening. J Pediatr Orthop, 2017, 37(Suppl 2): S1-S8.
3. Meleppuram JJ, Ibrahim S. Experience in fixation of infected non-union tibia by Ilizarov technique-a retrospective study of 42 cases. Rev Bras Ortop, 2017, 52(6): 670-675.
4. Nogueira MP, Queiroz AC, Melanda AG, et al. Results of ponseti brasil program: multicentric study in 1621 feet: preliminary results. J Pediatr Orthop, 2017, 37(3): e197-e201.
5. Manggala Y, Angthong C, Primadhi A, et al. The deformity correction and fixator-assisted treatment using Ilizarov versus Taylor spatial frame in the foot and ankle. Orthop Rev (Pavia), 2017, 9(4): 7337.