[矫正外翻畸形的内侧闭合楔形截骨术]。

IF 1 4区 医学 Q3 ORTHOPEDICS
Operative Orthopadie Und Traumatologie Pub Date : 2024-10-01 Epub Date: 2024-08-16 DOI:10.1007/s00064-024-00855-9
Wolf Petersen, Hasan Al Mustafa, Matin Häner, Johannes Buitenhuis, Karl Braun
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引用次数: 0

摘要

目标: 矫正胫骨近端外翻畸形:矫正胫骨近端外翻畸形:膝关节外侧骨关节炎或软骨损伤,外翻畸形 > 5°,胫骨近端内侧角 (MPTA) > 90°:胫骨内侧近端角度 手术技巧:胫骨结节内侧约 8-10 厘米的皮肤切口。在趾骨正上方插入两根会聚导丝,斜向上升,在腓骨顶端结束。用图像增强器控制导丝位置。用摆动锯进行截骨。移除楔形块并关闭截骨。使用内侧角稳定钢板进行骨合成:术后处理:部分负重 10-20 公斤,持续 2 周,然后逐步增加负重。活动度:自由:我们按照所述方法为 21 名患有外侧骨关节炎或软骨损伤的患者(17 名男性,4 名女性,平均年龄 51 岁)实施了该手术。内翻畸形从平均 5.6°减少到-0.5°。KOOS-PS(膝关节损伤和骨关节炎结果评分--物理功能简表)得分从 39.1 ± 14 分显著降至 25.8 ± 20 分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Medial closing wedge osteotomy for correction of valgus deformity].

Objective: Correction of a proximal tibial valgus deformity.

Indications: Lateral osteoarthritis of the knee or cartilage damage in a valgus deformity > 5° with a medial proximal tibial angle (MPTA) > 90°.

Contraindications: Medial proximal tibial angle < 90°, medial cartilage damage, medial meniscus loss.

Surgical technique: Skin incision medial of the tibial tuberosity approximately 8-10 cm. Insertion of two converging guidewires directly above the pes anserinus, ascending obliquely, and ending at the tip of the fibula. Control of the wire position with the image intensifier. Osteotomy with an oscillating saw. Removal of the wedge and closure of the osteotomy. Osteosynthesis with a medial angle-stable plate.

Postoperative management: Partial load bearing with 10-20 kg for 2 weeks, then step-wise increase in load. Mobility: free.

Results: We performed this surgery in the manner described in 21 patients with lateral osteoarthritis or cartilage damage (17 men, 4 women, average age: 51 years). The valgus deformity was reduced from an average of 5.6 to -0.5°. The KOOS-PS (Knee Injury and Osteoarthritis Outcome Score-Physical Function Short-form) score decreased significantly from 39.1 ± 14 to 25.8 ± 20 points.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
32
审稿时长
>12 weeks
期刊介绍: Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.
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