Department of Orthopaedics, Chang Gung Memorial Hospital, Chang Gung University, Gueishan, Taoyuan, Taiwan.
Int Orthop. 2012 Jun;36(6):1191-7. doi: 10.1007/s00264-012-1495-8. Epub 2012 Feb 4.
Traditionally, valgus knee deformity is predominately corrected by stabilisation with a plate inserted via the medial approach to the supracondylar region of the femur. However, this technique is unfavourable from both a biomechanical and a biological point of view. A revised retrograde dynamic locked nailing was developed to improve correction of this defect.
Forty-one knees with valgus deformity (average tibiofemoral angle, 22°; range, 16-29°) in 25 adult patients were treated by oblique femoral supracondylar varus osteotomy and stabilised with retrograde dynamic locked nails. Postoperatively, early ambulation with protected weight bearing and range of motion knee exercises were encouraged.
Thirty-five knees of 21 patients were followed-up for an average of 2.6 years (range, 1.1-4.5 years). All osteotomy sites healed with an average union period of 3.4 months (range, 2.5-5.0 months). There were no significant complications. At the latest follow-up, the average tibiofemoral angle was 7.1° valgus (range, 4-10° valgus). For all of the knees, the outcomes were satisfactory (p < 0.001).
The technique described here may be a feasible alternative for correction of valgus knee deformity. The advantages of this technique include the use of a biomechanically more appropriate method, a minimal complication rate and a high rate of satisfactory outcomes.
传统上，通过在股骨髁上区域的内侧入路插入钢板来稳定矫正外翻膝畸形。然而，从生物力学和生物学的角度来看，这种技术并不理想。开发了一种改良的逆行动力锁定钉来改善这种缺陷的矫正。
25 名成年患者的 41 个外翻畸形膝关节（平均胫股角为 22°；范围为 16°-29°）采用斜行股骨髁上内翻截骨术，并用逆行动力锁定钉固定。术后鼓励早期活动，保护负重和膝关节运动范围。
21 名患者中的 35 个膝关节平均随访 2.6 年（范围 1.1-4.5 年）。所有截骨部位均愈合，平均愈合时间为 3.4 个月（范围 2.5-5.0 个月）。无明显并发症。在最近的随访中，平均胫股角为 7.1°外翻（范围为 4°-10°外翻）。所有膝关节的结果均满意（p<0.001）。
这里描述的技术可能是矫正外翻膝畸形的一种可行替代方法。该技术的优点包括使用更符合生物力学的方法、并发症发生率低和满意度高。
