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病例报告:“Z”形截骨术——治疗布朗特病的一种新技术。

Case Report: 'Z' osteotomy - a novel technique of treatment in Blount's disease.

作者信息

Karuppal Raju, Mohan Rahul, Marthya Anwar, Ts Gopakumar, S Sandhya

机构信息

Department of Orthopedics, Govt. Medical College Kozhikode, Kerala Health University, Kerala, 673008, India.

IQRAA International hospital and research centre, Kozhikode, Kerala, 673008, India.

出版信息

F1000Res. 2015 Nov 12;4:1250. doi: 10.12688/f1000research.6770.1. eCollection 2015.

Abstract

Blount's disease is a progressive form of genu varum due to asymmetrical inhibition of the postero medial portion of the proximal tibial epiphysis. The surgical treatments involved in correction of Blount's disease are often technically demanding, complicated procedures.  These procedures can lead to prolonged recovery times and poor patient compliance. In such a context we are suggesting "fibulectomy with Z osteotomy" of the proximal tibia, a relatively simple and highly effective technique. This technique is based on correcting the mechanical axis of the lower limb thereby restoring growth from the medial physis of proximal tibia. We have used a new surgical technique, which includes fibulectomy followed by a Z-shaped osteotomy. We have used this simple technique in a 5 year-old boy with unilateral Blount's disease. The femoro-tibial angle was corrected from 18.2° of varus to 4.2° of valgus. The angular correction obtained after operation was 22°. There were no postoperative complications. This technique has the advantages of correcting both angular and rotational deformities simultaneously.  The purpose of this case study is to introduce a new surgical technique in the treatment of Blount's disease.

摘要

布朗特氏病是一种由于胫骨近端骨骺后内侧部分不对称抑制而导致的进行性膝内翻。矫正布朗特氏病所涉及的外科治疗通常是技术要求高且复杂的手术。这些手术可能导致恢复时间延长和患者依从性差。在这种情况下,我们建议对胫骨近端进行“腓骨切除术加Z形截骨术”,这是一种相对简单且高效的技术。该技术基于矫正下肢的机械轴,从而恢复胫骨近端内侧生长板的生长。我们采用了一种新的手术技术,包括腓骨切除术后进行Z形截骨术。我们已将这种简单技术应用于一名患有单侧布朗特氏病的5岁男孩。股胫角从内翻18.2°矫正至外翻4.2°。术后获得的角度矫正为22°。无术后并发症。该技术具有同时矫正角度和旋转畸形的优点。本病例研究的目的是介绍一种治疗布朗特氏病的新手术技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6343/4972087/58765bb44af9/f1000research-4-7274-g0000.jpg

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