| Objective: A retrospective analysis transfixation of the ankle intramedullary rod effect on congenital pseudarthrosis of the tibia’s distal tibia epiphyseal plate.Methods: Cases of clinical data collected from patients with CPT in March 2007 to December 2012 during the Hunan Province Children’s Hospital, met the inclusion criteria for a total of 25 cases. The method of classification of bone bridge in the X-ray Bright presented the patients were divided into bone bridge cases and no bone bridge cases group. There are cases where the bone bridge 6 cases, 19 cases of patients no bone bridge. According to the modified RUST scoring system to assess CPT healing. According to Paley proposed measuring method to measure the two groups tibia’s length,tibial epiphyseal plate diameter and the distal tibia’s force lines angle. Ankle valgus classification method using Malhotra’s method.Results:(1) Modified RUST score:The bone bridge cases group average score was 11.00±1.095(range 10 to 12),no bone bridge cases group average score was 11.47±1.124(range 8~12); two groups were RUST score was no significant difference(P> 0.05);(2) Limb length discrepancy:The bone bridge cases group tibia limb shortening average 3.348±1.327cm(range 1.05 ~ 4.97cm); no bone bridge cases group tibia limb shortening average 0.921±1.584cm(range 0~3.67cm); the two cases groups limb length discrepancy was statistically significant(P<0.05);(3) Intramedullary rod diameter:The bone bridge cases group average 0.483±0.0753cm(range 0.4~0.6cm); no bone bridge case group average of 0.405 ± 0.0405cm(range 0.3 ~ 0.5cm); intramedullary rod diameter of the two groups were statistically significant(P< 0.05);(4) Intramedullary rod stay time:The bone bridge case group average of 2.60±1.32 years(range 1.0 to 4.7 years);no bone bridge case group averaged 2.38 ± 0 82 years(range 1.3~3.7 years); two cases of intramedullary rod stay time difference was no statistically significant(P> 0.05);(5)Intramedullary rod proportion of the epiphyseal plate area:Bone bridge case group are 2.21±0.42%(range 1.70 to 2.75%); no bone bridge case group are 2.22 ± 0.65%(range 1.20 to 3.35%); two groups of intramedullary rod aproportion of the epiphyseal plate area ratio of no significant difference(P> 0.05);(6) Distal tibial force lines:The bone bridge case group LDTA average degree was 84.51±10.68°, ADTA average degree was 88.37±6.62°; no bone bridge case group LDTA average degree was 88.29±8.34°, ADTA average degree was 91.52±7.78°;the ADTA and LDTA of two groups abnormal rate was no significant difference(P> 0.05);(7) Ankle valgus: The no bone bridge case group: 0 grade 6 cases,Ⅰgrade 3 cases, Ⅱ grade 5 cases, Ⅲ grade 5 cases; bone bridge case group: 0 grade 2 cases,Ⅰ grade 0 cases, Ⅱ grade 2 cases, Ⅲ grade 2 cases; two groups of ankle valgus incidence difference was no statistically significant(P> 0.05);(8)Age at surgery:The no bone bridge case group average was 2.46±1.36 years(range 1.1 to 11.3 years); bone bridge case group average was 5.95±4.31 years(range 0.8 to 6.1 years);when the two groups were age at surgery was no statistically significant(P> 0.05).Conclusions: This study found that CPT patients after combined surgical technique treatment of ankle joint intramedullary rod fixation rare distal tibial epiphyseal plate formed bone bridge; the implant diameter and the epiphyseal plate bone bridge formation have a relationship, when the implant larger diameter of formation epiphyseal plate bone bridge the greater the likelihood. |
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