Department of Orthopaedics, Division of Orthopaedic Oncology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland.
Clin Orthop Relat Res. 2010 May;468(5):1264-8. doi: 10.1007/s11999-009-1093-2. Epub 2009 Sep 15.
Rotationplasty provides stable and durable biologic reconstruction after tumor resection around the knee and renders reliable results, in young patients. However, after resection of the tumor, there is often a mismatch between the circumference of the proximal (femoral) and the distal (tibial) parts. Because rotationplasty includes an intercalary amputation where the ends are readapted, there is always a mismatch of the proximal and distal circumferences of the soft tissue envelope. To facilitate skin closure without tension and to avoid impaired wound healing and subsequent infections, the type of incision is critical and must be carefully planned. We present a new incision technique for rotationplasty about the knee. Half of the difference of the incision length of the proximal and distal circumferences represents the base of the triangle proximally, medially and laterally of the thigh. After adapting both ends, the peak of this flat triangle is distally adapted via a vertical incision which allows it to match unequal circumferences. This technique was used in eight patients, in all of whom the wounds healed uneventfully.
旋转成形术为膝关节周围肿瘤切除术后的年轻患者提供了稳定且持久的生物重建，并取得了可靠的效果。然而，在肿瘤切除后，近端（股骨）和远端（胫骨）部分的周长往往不匹配。由于旋转成形术包括在中间截断，因此两端需要重新适应，因此软组织包膜的近端和远端周长总是不匹配。为了便于无张力闭合皮肤，避免伤口愈合不良和随后的感染，切口类型至关重要，必须仔细规划。我们提出了一种膝关节旋转成形术的新切口技术。近端和远端周长的切口长度之差的一半代表大腿近端、内侧和外侧三角形的基部。适应两端后，通过一个垂直切口使这个扁平三角形的顶点向远端适应，从而使不等周长相匹配。该技术已在 8 名患者中使用，所有患者的伤口均愈合良好。
