Staubli Alex E, De Simoni Carlo, Babst Reto, Lobenhoffer Philipp
Department of Orthopaedics, Kantonsspital Luzern, Switzerland.
Injury. 2003 Nov;34 Suppl 2:B55-62. doi: 10.1016/j.injury.2003.09.025.
High Tibial Osteotomy (HTO) is an established treatment for unicompartmental osteoarthritis of the knee with malalignment. The classic procedure for correcting varus deformity is the lateral closed wedge osteotomy of the tibia with osteotomy of the fibula. The disadvantages of this technique are well known. Open wedge osteotomy from the medial side eliminates the risk of compartment syndrome and peroneal nerve injuries. A new fixation device (TomoFix) with an adapted surgical technique allows stable fixation of the osteotomy without the need to fill the osteotomy gap with bone grafts. In a prospective study, 92 consecutive cases were treated with this procedure. Bony healing with remodelling of the medial and posterior cortical bone was observed. Full weight-bearing was possible ten weeks after surgery. There were no implant failures. Complications included one delayed union, two revarisations and one deep infection.
高位胫骨截骨术（HTO）是治疗伴有力线不正的膝关节单髁骨关节炎的一种成熟方法。矫正内翻畸形的经典手术是胫骨外侧闭合楔形截骨术并同时行腓骨截骨术。该技术的缺点众所周知。从内侧进行开放楔形截骨可消除骨筋膜室综合征和腓总神经损伤的风险。一种新型固定装置（TomoFix）及适配的手术技术可实现截骨部位的稳定固定，无需用骨移植填充截骨间隙。在一项前瞻性研究中，连续92例患者接受了该手术治疗。观察到内侧和后侧皮质骨愈合并重塑。术后十周即可完全负重。未出现植入物失败情况。并发症包括1例延迟愈合、2例内翻复发和1例深部感染。
