https://scholars.lib.ntu.edu.tw/handle/123456789/335582
標題: | Reducing limping by tibial lengthening along nails in adult unilateral developmental dysplasia of the hip with high dislocation | 作者: | SHIER-CHIEG HUANG TING-MING WANG Chou, Yang-Chen Lin, Jinn |
關鍵字: | Adults;Bone lengthening;Congenital hip dysplasia;Developmental disabilities;Leg length inequality | 公開日期: | 2008 | 卷: | 107 | 期: | 7 | 起(迄)頁: | 540-547 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Treatment of adult neglected developmental dysplasia of the hip (DDH) with high dislocation is still not established. The main concern of young patients is leg-length discrepancy (LLD), which leads to limping gait and impaired body image. Such patients usually ask for a minimally invasive treatment that can improve the LLD. Methods: Between 1993 and 2003, 17 patients with neglected DDH with high dislocation (mean age, 22.8 years) were treated by tibial lengthening using the Ilizarov external fixator over an intramedullary nail. The inclusion criteria were unmarried young adults, unilateral lesion, significant limping or unsightly gait with psychologic discomfort, marked shortening > 4 cm with the block test, and benefit from a shoe-lift. Exclusion criteria were patients older than 30 years, hip pain as the chief complaint, and compensated low hip dislocation without significant limping. Results: All 17 patients had eventual bone consolidation without further operation. The mean external fixation index was 14.2 day/cm. Bone formation was good in all patients with a mean consolidation index of 57.7 day/cm. At an average follow-up period of 7.8 years, the limping was much improved from a moderate or severe degree to a mild degree in all patients. No patients had equinus contracture. All patients were satisfied with their treatment results. There were two complications: transient loss of big toe extension and mild wound infection. Conclusion: Tibial lengthening can improve limping in adult patients with neglected DDH and high dislocation with a low morbidity. Lengthening along intramedullary nails can effectively reduce the external fixation time, improve bone formation, and prevent complications. ©2008 Elsevier & Formosan Medical Association. |
URI: | http://www.scopus.com/inward/record.url?eid=2-s2.0-50049098048&partnerID=MN8TOARS http://scholars.lib.ntu.edu.tw/handle/123456789/335582 |
DOI: | 10.1016/S0929-6646(08)60167-9 |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。