Wolff A M, Krackow K A
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Clin Orthop Relat Res. 1990 Jan(250):207-15.
Nonunion of proximal tibial osteotomy is a rare occurrence. Treatment goals should emphasize preservation of proximal tibial bone stock in view of possible subsequent total knee arthroplasty (TKA). Previous reports, in mostly smaller series, have emphasized the use of external fixation in the management of this problem. There have been no previous reports regarding the use of internal fixation in the treatment of nonunion occurring after tibial osteotomy performed proximal to the tibial tubercle. In this report, the results of internal fixation in the treatment of six cases of nonunion after proximal tibial osteotomy are analyzed with regard to functional and roentgenographic results. Healing of the nonunion was obtained in all six patients. Realignment of angulatory deformities was uniformly achieved. Achievement of union and correction of axial malalignment, in addition to creating an improved substrate for later TKA, provided other objectives as well. Elimination of pain and instability at the nonunion site allowed these patients to derive some of the intended benefits from the original osteotomy.
胫骨近端截骨不愈合是一种罕见的情况。鉴于可能随后需要进行全膝关节置换术（TKA），治疗目标应强调保留胫骨近端的骨量。以往的报告大多是较小的系列研究，强调使用外固定来处理这个问题。以前没有关于在胫骨结节近端进行截骨术后发生的不愈合使用内固定治疗的报告。在本报告中，分析了6例胫骨近端截骨术后不愈合采用内固定治疗的功能和影像学结果。所有6例患者的不愈合均获愈合。均成功矫正了成角畸形。实现骨愈合和矫正轴向畸形，除了为后期的全膝关节置换术创造更好的条件外，还带来了其他益处。消除不愈合部位的疼痛和不稳定，使这些患者从最初的截骨术中获得了一些预期的益处。
