Objective:To investigate the clinical improvement of limping gait in patients with ankylotic hips and limb length discrepancy.Methods:From 1996 to 2005,12 patients with ankylotic hips and limb length discrepancy were treated by distraction osteogenesis with a mono-lateral external fixator and an intramedullary nail.The limb length discrepancy was 6.20-12.50 (median 8.45) cm.Limping gait was classified according to the recommendations of the American Academy of Orthopedic Surgeons/Hip Society and scored according to Harris:no limping scored 11 points,mild limping scored 8 points,moderate limping scored 5 points,while severe limping scored 0 points.Limping gait was severe in all patients pre-operatively and the total score was 0.Results:All patients were followed up for 30.00-46.00 (median 38.55) months,and all reported improvement in limping gait.The gain in length was 6.00-12.50 (median 8.20) cm,and the mean residual limb length discrepancy was 0-0.50 (median 0.20) cm.The total treatment time was 41.00-82.00 (median 61.50) weeks,the lengthening time was 14.00-38.00 (median 29.55) weeks.At the last follow-up,10patients had mild limping gait and 2 had moderate limping gait; the total score was 90.00.The median score was 7.50 (P25 was 8.00,P75 was 8.00).According to Wilcoxon signed rank test,the post-operative limping gait scores were significantly higher than pre-operative (P=0.001 ).Conclusion:Femoral lengthening can improve the limping gait significantly in ankylotic hips and limb length discrepancy.%目的:探讨股骨延长术在提高髋关节强直并肢体短缩年轻患者跛行步态的临床效果.方法:自1996至2005年共收治12名髋关节强直并肢体短缩的患者,所有患者均采用外固定支架结合髓内钉进行延长.患者肢体短缩6.20～12.50(中位数8.45) cm.根据美国骨科医师协会的评定标准,所有患者都严重跛行.根据Harris评分标准(无跛行11分,轻度8分,中度5分,重度0分),术前跛行评分为0分.结果:所有患者均获得随访,随访时间30.00～46.00(中位数38.55)个月.患者肢体延长6.00～12.50(中位数8.20) cm,残余肢体短缩0～0.50(中位数0.20)cm.患者治疗时间41.00～82.00(中位数61.50)周,延长时间14.00～38.00(中位数29.55)周.10例患者为轻度跛行,2例为中度跛行.所有患者跛行评分总分为90.00分,中位数评分8.00分(P25为8.00,P75为8.00).应用Wiicoxon 符号秩检验进行统计学分析,术后跛行评分较较术前(0分)有明显的改善( P=0.001).结论:股骨延长术能显著改善髋关节强直并肢体短缩年轻患者的跛行步态.
展开▼
