percutaneous epiphyseal fusion

Percutaneous osteophyte fusion for surgical treatment of lower extremity shortening. Osteophyseal fusion was initiated by Phemister by fusing one to several epiphyses of the longer limb. Because the short limbs are still growing, it is necessary to make accurate calculations before surgery to make the limbs reach the same length. The prediction method is quite complicated, so the application of the surgery is limited. Most scholars believe that if you need 2 to 5 cm of limb shortening, it is feasible to perform osteophyte fusion. Some scholars suggest that it is best to do the fusion of the femoral epiphysis first. After 1 to 2 years, the iliac crest is merged to avoid excessive shortening of the limbs and unequal length of the lower limbs. Treating diseases: surgical steps 1. Incision and exposure A lateral or longitudinal incision of about 1.5 cm is made on the inside or outside of the femoral condyle. Use a smooth Sterling or Kirschner wire as a guide pin into the seesaw until it is outside. Use the TV X-ray machine to check the two sides of the front side so that the needle is placed correctly in the fascia. 2. Remove the seesaw Through the guide pin, the hollow reaming drill is inserted into the center of the seesaw under the surveillance of the television X-ray machine. After removing the reamer, remove the slab with a high-speed air drill with a tooth. Care should be taken to protect the skin from skin necrosis. The incision can also be enlarged so that it can be inserted into a 6mm drill bit, the cortical bone can be widened, and the jaws can be scraped with straight or various angles of the curette. The front and rear sides, the proximal and distal ends, and the peripheral jaws are removed, especially the remaining slabs at the periphery, so that they are in the shape of a "bull's eye" on the television X-ray machine. It is not necessary to completely remove all the seesaws, but under the monitoring of the television X-ray machine, the removal of the seesaw and surrounding bone tissue should form a low-density transmission zone. If the shot target image is not reached, the cortical bone and the tarsal plate should be removed repeatedly with a curette or a large reamer. At the proximal end of the humerus, the same method can be used. The proximal humerus epiphysis may not be treated, especially if the osteophyte inhibition required at the proximal end of the humerus is less than 2.5 cm. If you need to remove the proximal humerus, in order to avoid damage to the common peroneal nerve, it is best to perform under direct vision. An auxiliary incision is made to expose the proximal side of the humerus, and the tarsal plate is removed with a curette, hand drill or reaming drill. 3. Repeat the irrigation of the incision with isotonic saline to remove cartilage and cancellous bone. The incision was sutured layer by layer.