{"title":"使用六足架矫正膝后屈畸形:一个病例系列和文献回顾。","authors":"Liam Johnson, James McCammon, Anthony Cooper","doi":"10.5005/jp-journals-10080-1528","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim and objective: </strong>Genu recurvatum is a rare deformity for which minimal literature exists. Non-operative management typically gives unsatisfactory results. This study aims to evaluate the treatment of genu recurvatum with a hexapod frame.</p><p><strong>Materials and methods: </strong>A single-center retrospective chart review of genu recurvatum cases treated with a hexapod fixator application was performed. Radiographic parameters included the following: leg length discrepancy (LLD), angle of recurvatum, angle of tilt of the tibial plateau, patellar height and anatomic proximal posterior tibial angle (aPPTA). Radiographic and functional results were evaluated.</p><p><strong>Results: </strong>A total of five patients with six limbs corrected with a hexapod frame were found. Aetiology included post-traumatic (2), post-infectious (1) and idiopathic (3). The mean age at application was 13.36 (5.5-18.0) years. The total mean time in the fixator was 225 (160-412) days. The LLD decreased from a mean of 35.6 mm (0.7-50) preoperatively to a mean of 14.8 (1.0-39.3) postoperatively. The average patellar height remained similar 0.97 (0.69-1.2)-0.97 (0.51-1.6). The angle of the tilt of the tibial plateau improved from a preoperative mean of 66° (58.5-73.5°)-92.5° (80-98.5°). The angle of recurvatum improved from a preoperative mean of 26.4° (18.5-31°)-5.0° (0-9°). The aPTTA improved from (102-118°)-85.5° (77-96°).</p><p><strong>Conclusion: </strong>Osteotomy distal to the tibial tuberosity and deformity correction using a hexapod frame allows for multiplanar correction. Throughout treatment, soft tissue management with physical therapy remained key to prevent knee contracture.</p><p><strong>Clinical significance: </strong>A hexapod frame is a safe and accurate technique that allows correction of genu recurvatum along with concomitant deformities with low risk of complications.</p><p><strong>How to cite this article: </strong>Johnson L, McCammon J, Cooper A. Correction of Genu Recurvatum Deformity Using a Hexapod Frame: A Case Series and Review of the Literature. Strategies Trauma Limb Reconstr 2021;16(2):116-119.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"16 2","pages":"116-119"},"PeriodicalIF":1.0000,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/c7/stlr-16-116.PMC8578241.pdf","citationCount":"2","resultStr":"{\"title\":\"Correction of Genu Recurvatum Deformity Using a Hexapod Frame: A Case Series and Review of the Literature.\",\"authors\":\"Liam Johnson, James McCammon, Anthony Cooper\",\"doi\":\"10.5005/jp-journals-10080-1528\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim and objective: </strong>Genu recurvatum is a rare deformity for which minimal literature exists. Non-operative management typically gives unsatisfactory results. This study aims to evaluate the treatment of genu recurvatum with a hexapod frame.</p><p><strong>Materials and methods: </strong>A single-center retrospective chart review of genu recurvatum cases treated with a hexapod fixator application was performed. Radiographic parameters included the following: leg length discrepancy (LLD), angle of recurvatum, angle of tilt of the tibial plateau, patellar height and anatomic proximal posterior tibial angle (aPPTA). Radiographic and functional results were evaluated.</p><p><strong>Results: </strong>A total of five patients with six limbs corrected with a hexapod frame were found. Aetiology included post-traumatic (2), post-infectious (1) and idiopathic (3). The mean age at application was 13.36 (5.5-18.0) years. The total mean time in the fixator was 225 (160-412) days. The LLD decreased from a mean of 35.6 mm (0.7-50) preoperatively to a mean of 14.8 (1.0-39.3) postoperatively. The average patellar height remained similar 0.97 (0.69-1.2)-0.97 (0.51-1.6). The angle of the tilt of the tibial plateau improved from a preoperative mean of 66° (58.5-73.5°)-92.5° (80-98.5°). The angle of recurvatum improved from a preoperative mean of 26.4° (18.5-31°)-5.0° (0-9°). The aPTTA improved from (102-118°)-85.5° (77-96°).</p><p><strong>Conclusion: </strong>Osteotomy distal to the tibial tuberosity and deformity correction using a hexapod frame allows for multiplanar correction. Throughout treatment, soft tissue management with physical therapy remained key to prevent knee contracture.</p><p><strong>Clinical significance: </strong>A hexapod frame is a safe and accurate technique that allows correction of genu recurvatum along with concomitant deformities with low risk of complications.</p><p><strong>How to cite this article: </strong>Johnson L, McCammon J, Cooper A. Correction of Genu Recurvatum Deformity Using a Hexapod Frame: A Case Series and Review of the Literature. 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引用次数: 2
摘要
目的和目的:膝后屈是一种罕见的畸形，文献记载很少。非手术治疗通常不能令人满意。本研究的目的是评估六足架治疗膝内翻。材料和方法:我们对使用六足固定架治疗膝内翻的病例进行了单中心回顾性分析。影像学参数包括:腿长差(LLD)、胫骨平台倾角、胫骨平台倾角、髌骨高度和解剖胫骨近后侧角(aPPTA)。评估影像学和功能结果。结果:共发现5例用六足架矫正的6肢患者。病因包括创伤后(2例)、感染后(1例)和特发性(3例)。平均年龄为13.36(5.5-18.0)岁。固定物的总平均时间为225(160-412)天。LLD由术前平均35.6 mm(0.7-50)降至术后平均14.8 mm(1.0-39.3)。平均髌骨高度为0.97(0.69-1.2)-0.97(0.51-1.6)。胫骨平台倾斜角度从术前平均66°(58.5-73.5°)-92.5°(80-98.5°)改善。手术前的平均角度为26.4°(18.5-31°)-5.0°(0-9°)。aPTTA从(102-118°)改进到85.5°(77-96°)。结论:胫骨结节远端截骨和畸形矫正使用六足架允许多平面矫正。在整个治疗过程中，软组织管理与物理治疗仍然是防止膝关节挛缩的关键。临床意义:六足架是一种安全、准确的技术，可以矫正膝内翻及伴随畸形，并发症风险低。Johnson L, McCammon J, Cooper a .使用六足架矫正膝后屈畸形:病例系列和文献回顾。创伤肢体重建[j]; 2011;16(2):116-119。
Correction of Genu Recurvatum Deformity Using a Hexapod Frame: A Case Series and Review of the Literature.
Aim and objective: Genu recurvatum is a rare deformity for which minimal literature exists. Non-operative management typically gives unsatisfactory results. This study aims to evaluate the treatment of genu recurvatum with a hexapod frame.
Materials and methods: A single-center retrospective chart review of genu recurvatum cases treated with a hexapod fixator application was performed. Radiographic parameters included the following: leg length discrepancy (LLD), angle of recurvatum, angle of tilt of the tibial plateau, patellar height and anatomic proximal posterior tibial angle (aPPTA). Radiographic and functional results were evaluated.
Results: A total of five patients with six limbs corrected with a hexapod frame were found. Aetiology included post-traumatic (2), post-infectious (1) and idiopathic (3). The mean age at application was 13.36 (5.5-18.0) years. The total mean time in the fixator was 225 (160-412) days. The LLD decreased from a mean of 35.6 mm (0.7-50) preoperatively to a mean of 14.8 (1.0-39.3) postoperatively. The average patellar height remained similar 0.97 (0.69-1.2)-0.97 (0.51-1.6). The angle of the tilt of the tibial plateau improved from a preoperative mean of 66° (58.5-73.5°)-92.5° (80-98.5°). The angle of recurvatum improved from a preoperative mean of 26.4° (18.5-31°)-5.0° (0-9°). The aPTTA improved from (102-118°)-85.5° (77-96°).
Conclusion: Osteotomy distal to the tibial tuberosity and deformity correction using a hexapod frame allows for multiplanar correction. Throughout treatment, soft tissue management with physical therapy remained key to prevent knee contracture.
Clinical significance: A hexapod frame is a safe and accurate technique that allows correction of genu recurvatum along with concomitant deformities with low risk of complications.
How to cite this article: Johnson L, McCammon J, Cooper A. Correction of Genu Recurvatum Deformity Using a Hexapod Frame: A Case Series and Review of the Literature. Strategies Trauma Limb Reconstr 2021;16(2):116-119.
期刊介绍：
Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.
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