Lampert C, Thomann B, Brunner R
Klinik für Orthopädische Chirurgie, Kantonsspital und Kinderspital, St. Gallen.
Orthopade. 2000 Sep;29(9):802-7. doi: 10.1007/s001320050529.
Tibial torsion defects are usually not clinically evident and, hence, are often overlooked. Clinical examination and CT scan have proved to be the best ways of measuring static tibial torsion, whereas dynamic measurements are usually performed in the clinic and the "gait laboratory." Only few studies have determined there to be a connection between a torsion defect in the lower leg and expected pathological conditions of the knee and ankle joints. However, patellofemoral instability, Osgood-Schlatter disease, osteochondrosis dissecans are increasingly being found in cases of increased external tibial torsion and arthrosis in reduced torsion. Although spontaneous correction may occur in certain cases, in others the only way to correct the condition is by employing physiologic torsion. Conservative treatment methods such as bandages or orthosis have been shown to not have any effect on torsion; thus, surgical treatment is the only successful way to correct a pathologic angle of rotation of the tibia. For this, supramalleolar osteotomy with fixation using Kirscher wires and plaster or an external fixator are the most common treatments.
胫骨扭转缺陷通常在临床上并不明显，因此常常被忽视。临床检查和CT扫描已被证明是测量静态胫骨扭转的最佳方法，而动态测量通常在诊所和“步态实验室”进行。只有少数研究确定小腿扭转缺陷与膝关节和踝关节的预期病理状况之间存在联系。然而，在胫骨外旋增加的病例中越来越多地发现髌股关节不稳定、奥斯古德-施拉特病、剥脱性骨软骨炎，而在扭转减少的病例中则发现关节病。虽然在某些情况下可能会发生自发矫正，但在其他情况下，矫正这种情况的唯一方法是采用生理性扭转。事实证明，诸如绷带或矫形器等保守治疗方法对扭转没有任何效果；因此，手术治疗是矫正胫骨病理性旋转角度的唯一成功方法。为此，使用克氏针和石膏或外固定器固定的踝上截骨术是最常见的治疗方法。
