Oh Chang-Wug, Kim Sung-Jung, Park Sung-Ki, Kim Hee-June, Kyung Hee-Soo, Cho Hwan-Sung, Park Byung-Chul, Ihn Joo-Chul
Department of Orthopedic Surgery, Kyungpook National University Hospital, 50, 2-Ga, Samdok, Chunggu, Daegu, 700-721, Korea.
J Orthop Sci. 2011 Jan;16(1):44-50. doi: 10.1007/s00776-010-0006-2. Epub 2011 Jan 20.
Gradual correction of varus deformity of the proximal tibia is generally accepted and produces good results. However, most studies have used circular external fixators, which are complex and cause patient discomfort. This study was undertaken to determine the efficacy of hemicallotasis with a unilateral external fixator for correction of varus deformity of the proximal tibia.
Thirteen patients (21 legs, 8 bilateral) were included in this study: 6 with constitutional bowing, 3 with a malunion, 2 with Blount's disease, and 2 with Turner syndrome. There were 7 males and 6 females of mean age 21 years (range 13-40). With an oblique osteotomy on the proximal tibia, a unilateral external fixator was placed on the medial side. Using a distraction of 1 mm/day, the external fixator was removed after consolidation of the callus.
Surgery corrected medial proximal tibia angle from a preoperative average of 75.1° (64°-81°) to 88.6° (86°-90°) at final follow-up. Average tibiofemoral angle improved from -7° to 6.8°. The duration of external fixation averaged 101.3 days and the external fixation index was 70 days/cm. No patient had a limited ambulation, and all recovered preoperative range of knee motion (mean 130.1°) at final follow-up. Seven minor complications (pin tract infection, clamp loosening) and 1 major complication (uncorrected genu procurvatum) were observed.
Hemicallotasis using a unilateral external fixator was found to be a safe and simple corrective procedure for varus deformity of the proximal tibia, with few complications.
胫骨近端内翻畸形的逐步矫正已被广泛接受且效果良好。然而，大多数研究使用的是环形外固定器，其结构复杂且会给患者带来不适。本研究旨在确定单侧外固定器半骨骺牵张术矫正胫骨近端内翻畸形的疗效。
本研究纳入了13例患者（21条腿，8例双侧）：6例为先天性弓形腿，3例为骨折不愈合，2例为布朗特病，2例为特纳综合征。患者共7名男性和6名女性，平均年龄21岁（范围13 - 40岁）。在胫骨近端进行斜行截骨后，在内侧放置单侧外固定器。以每天1毫米的牵张速度进行牵张，骨痂巩固后拆除外固定器。
手术使胫骨近端内侧角从术前平均75.1°（6�° - 81°）矫正至末次随访时的88.6°（86° - 90°）。胫股角平均从 - 7°改善至6.8°。外固定平均持续时间为101.3天，外固定指数为70天/厘米。没有患者出现行走受限，所有患者在末次随访时均恢复了术前膝关节活动范围（平均130.1°）。观察到7例轻微并发症（针道感染、夹钳松动）和1例严重并发症（膝前凸未矫正）。
使用单侧外固定器进行半骨骺牵张术是一种安全、简单的矫正胫骨近端内翻畸形的方法，并发症较少。
