Postel M, Senly G
Rev Chir Orthop Reparatrice Appar Mot. 1978 Dec;64(8):667-76.
Thirteen tibiae and seven femora suffering from bowing due to Paget's disease have been streightened operatively. In the tibiae, the deformities were of metaphysial genu varum with bowing in the sagittal plane of an average of 30 degrees combined with some medial rotation. In the femora, the main curve was anterolateral with some medial rotation and coxa vara. Seventeen cases united uneventfully after osteotomy. In three cases, there were septic complications, union occurred after removal of the internal fixation. Bowing recurred in three cases. The recurrence appeared to be related to incomplete correction leading to persistent mechanical strain on bones affected by rapid bone turnover. Inadequate internal fixation may also be a factor. All other cases were functionally improved by correction. Oblique osteotomy is indicated for the correction of tibial deformity when there is moderate medial rotation. Transverse osteotomy with fixation by intramedullary nailing is indicated for correction of femoral deformities.
13例因佩吉特病导致弯曲的胫骨和7例股骨已通过手术矫正变直。在胫骨中,畸形为干骺端膝内翻,矢状面平均弯曲30度,并伴有一定程度的内旋。在股骨中,主要弯曲为前外侧,伴有一定程度的内旋和髋内翻。17例截骨术后顺利愈合。3例出现感染并发症,取出内固定后愈合。3例出现弯曲复发。复发似乎与矫正不完全导致快速骨转换所影响的骨骼持续受到机械性应力有关。内固定不足也可能是一个因素。所有其他病例通过矫正功能均得到改善。当存在中度内旋时,斜行截骨术适用于矫正胫骨畸形。横行截骨加髓内钉固定适用于矫正股骨畸形。