| 股骨髁上截骨治疗中青年外翻性膝骨关节炎 |
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Received:November 21, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 肖仕辉 |
XIAO Shi-hui |
来宾市人民医院关节创伤骨科, 广西 来宾 546100 |
Department of Joint and Trauma Surgery, People's Hospital of Laibin, Laibin 546100, Guangxi, China |
xiaoshihui007@126.com |
| 刘丁玮 |
LIU Ding-wei |
来宾市人民医院关节创伤骨科, 广西 来宾 546100 |
Department of Joint and Trauma Surgery, People's Hospital of Laibin, Laibin 546100, Guangxi, China |
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| 杨福成 |
YANG Fu-cheng |
来宾市人民医院关节创伤骨科, 广西 来宾 546100 |
Department of Joint and Trauma Surgery, People's Hospital of Laibin, Laibin 546100, Guangxi, China |
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| 张向敏 |
ZHANG Xiang-min |
来宾市人民医院关节创伤骨科, 广西 来宾 546100 |
Department of Joint and Trauma Surgery, People's Hospital of Laibin, Laibin 546100, Guangxi, China |
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| 期刊信息：《中国骨伤》2017年30卷，第8期，第735-738页 |
| DOI：10.3969/j.issn.1003-0034.2017.08.011 |
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目的：探讨股骨髁上外侧开放性楔形截骨治疗外翻性膝骨关节炎的临床疗效。
方法：自2008年4月至2015年6月，对21例（23膝）符合纳入标准的外翻性膝骨关节炎患者，采取股骨外髁上开放性楔形截骨后自体髂骨植骨并股骨远端解剖钢板内固定的手术方式进行治疗。男8例（8膝），女13例（15膝），年龄30~54岁，平均41.2岁，所有患者伴有膝关节外侧间室疼痛及外翻畸形，术前通过下肢负重位全长X线测量出胫股角平均为（162.0±2.6）°。通过观察术后骨愈合时间、手术并发症，比较治疗前后膝关节炎进展情况、HSS评分及胫股角等，综合评价该手术方法治疗外翻性膝关节炎的效果。
结果：所有患者术后膝关节外翻畸形得到矫正，骨愈合时间（3.9±1.5）个月，未发现明显延迟愈合或不愈合病例，无严重并发症发生。HSS膝关节总评分从术前的57.3±3.1提高到末次随访时的88.6±2.7。胫股角提高到术后的（176.0±1.4）°。
结论：股骨髁上开放性楔形截骨解剖入路清晰，术中容易控制截骨量，能够有效矫正膝关节外翻畸形，同时改善膝关节功能，是治疗中青年外翻性膝骨关节炎的有效方法。 |
| [关键词]:外翻畸形 膝骨关节炎 股骨截骨 |
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| Femoral supracondylar osteotomy for the treatment of valgus knee osteoarthritis in young and middle aged patients |
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Abstract:
Objective: To evaluate the clinical efficacy of open supracondylar osteotomy of the femoral condyle for the treatment of valgus knee osteoarthritis.
Methods: From April 2008 to June 2015,21 patients with valgus knee osteoarthritis underwent an open wedge femoral supracondylar osteotomy using the distal femur dissection plates combined with autologous iliac bone graft for the bone defect. There were 8 males (8 knees) and 13 females (15 knees),ranging in age from 30 to 54 years old,with a mean age of 41.2 years old. All the patients had valgus deformity and knee joint pain in the lateral compartment. The average tibiofemoral angle was (162.0±2.6)° which was measured on the image of preoperative lower extremity weight-bearing X-ray. Clinical outcomes were comprehensively assessed according to the bone healing time,postoperative complications,progress of knee osteoarthritis after operation,the Hospital for Special Surgery rating system (HSS),and tibiofemoral angle before and after operation.
Results: All 21 patients were followed up,the valgus deformity of knee joint was corrected in all patients after operation. No obvious delayed union or nonunion were found,and no serious complications were found. The HSS knee score was improved from the preoperative 57.3±3.1 to the final follow-up time 88.6±2.7. Tibiofemoral angle was improved to the postoperative(176.0±1.4)°.
Conclusion: Open wedge femoral supracondylar osteotomy has a clear surgical approach,and it is easy to control the bone mass of osteotomy and can effectively correct the valgus deformity and improve the function of knee joint using this method. It is an effective method for the treatment of valgus knee osteoarthritis in young and middle aged patients. |
| KEYWORDS:Valgus deformity Knee osteoarthritis Femoral osteotomy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 肖仕辉,刘丁玮,杨福成,张向敏.股骨髁上截骨治疗中青年外翻性膝骨关节炎[J].中国骨伤,2017,30(8):735~738 |
| 英文格式: | XIAO Shi-hui,LIU Ding-wei,YANG Fu-cheng,ZHANG Xiang-min.Femoral supracondylar osteotomy for the treatment of valgus knee osteoarthritis in young and middle aged patients[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(8):735~738 |
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