静脉畸形继发肢体挛缩的多学科联合诊疗OA

Objective To summarize the application of multidisciplinary treatment in the limb contracture secondary to venous malformation.Methods From March 2024 to December 2024,the Interventional Ortho-Plastic Surgery Group admitted 15 patients with limb contracture secondary to venous malformation into the retrospective monocentric research,including 6 males and 9 females,aged from 9-27 years,with an average age of 17.8 years.Among them,there were 6 cases of wrist flexion deformity,1 case of knee flexion deformity,1 case of ankle dorsiflexion deformity,and 7 cases of equinus.All patients were treated with multidisciplinary treatment in our center.Microsurgical intratumorally resection technology were used to perform venous malformation resection,and then Ilizarov technique was used to perform external fixation and pinning in the anatomical safe area.The external fixator adapted to the patient's limb was installed and fixed,and then traction control was implemented to continuously and slowly correct limb contracture.At the same time,the resected lesion tissue was tested by the targeted next generation sequencing,and feasibility of oral targeted medication was evaluated according to the sequencing results combined with clinical manifestation.Results All 15 patients included did not experience nerve damage,abnormal bleeding,peripheral circulation disorder,obvious needle tract infection or deep vein thrombosis during the whole procedure.The patients were followed up for 2 to 6 months,with an average follow-up time of 3.7 months.All contracted limb deformities were satisfactorily corrected.Range of motion was corrected by 64%-100%,with an average percentage of 80.5%.Conclusion The multidisciplinary treatment of limb contracture secondary to venous malformations was composed of microsurgical intratumoral dissection and resection of lesions,targeted medicine under the guidance of next-generation sequencing,and Ilizarov technique external fixation,which is proven safe and effective.