Zaki Saeed H, Rae Paul J
Wrightington Hospital for Joint diseases, Appley Bridge, United Kingdom.
Acta Orthop Belg. 2009 Jun;75(3):360-7.
Proximal tibial valgus osteotomy is one of the treatment options for painful medial compartment osteoarthrosis and varus deformity of the knee in a young patient. We report our experience with medial opening wedge tibial osteotomy using the Tomofix plate in 46 patients (50 knees). The mean age was 39.5 years (range 30-49). All were male. Mean duration of follow-up was 60 months (36-72 months). There were no non-unions of the osteotomy site and the medial open-wedge healed without any need for bone graft or bone substitutes. There was functional improvement, as seen from the Oxford and Knee Society scores. Preoperative average knee flexion was 110 degrees (range, 90 - 125 degrees) which remained unchanged. The mean preoperative tibio-femoral angle (mechanical) was 7 degrees varus (range, 5-10 degrees); the postoperative angle was 6 degrees valgus (range 5 degrees-8 degrees). One knee was revised to total knee replacement after two years and was considered a failure. The Tomofix plate provided immediate stability, satisfactory healing of the osteotomy site without the need for bone graft or bone substitutes, and good functional results in young patients with isolated medial compartment degenerative disease.
胫骨近端外翻截骨术是治疗年轻患者膝关节内侧间室骨关节炎伴内翻畸形疼痛的治疗选择之一。我们报告了使用Tomofix钢板进行内侧开口楔形胫骨截骨术治疗46例患者（50膝）的经验。平均年龄为39.5岁（范围30 - 49岁）。均为男性。平均随访时间为60个月（36 - 72个月）。截骨部位无骨不连，内侧开口楔形截骨愈合良好，无需植骨或骨替代物。从牛津膝关节评分和膝关节协会评分来看，功能有改善。术前平均膝关节屈曲度为110度（范围90 - 125度），术后保持不变。术前平均胫股角（力学角度）为内翻7度（范围5 - 10度）；术后角度为外翻6度（范围5度 - 8度）。1例膝关节在两年后翻修为全膝关节置换术，被视为失败病例。Tomofix钢板能提供即时稳定性，截骨部位愈合良好，无需植骨或骨替代物，对于单纯内侧间室退行性疾病的年轻患者能取得良好的功能结果。
