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使用螺钉和不可吸收丝线进行股骨远端半骨骺阻滞术治疗特发性膝外翻。12例膝关节的初步结果

Distal femoral hemiepiphysiodesis using screw and non-absorbable filament for the treatment of idiopathic genu valgum. Preliminary results of 12 knees.

作者信息

Martínez G, Drago S, Avilés C, Ibañez A, Hodgson F, Ramírez C

机构信息

Department of Traumatology and Orthopedics, Clinical Hospital of Pontificia Universidad Católica de Chile, Santiago, Chile.

Department of Traumatology and Orthopedics, Clinical Hospital of Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Orthop Traumatol Surg Res. 2017 Apr;103(2):269-273. doi: 10.1016/j.otsr.2016.11.014. Epub 2017 Jan 9.

Abstract

INTRODUCTION

Different techniques for gradual correction of angular deformities of lower limbs exist. Screws and nonabsorbable filament has been described as an effective alternative for transitory hemiepiphysiodesis in New Zealand rabbits.

HYPOTHESIS

Hemiepiphysiodesis using screws and non-absorbable filament is effective in pediatric population, for correction of genu valgum.

METHODS

Retrospective evaluation, 12 knees in 6 patients younger than 15 years (3 female), operated because of genu valgum. An anchoring system with two 4.0mm cancellous screw with metal washer joined by FiberWire #2.0 filament. Initial and final intermalleolar distance (IMD) and mechanical lateral distal femoral angle were compared, recording complications. Mann-Whitney test was used for statistics, with significance value <0.05.

RESULTS

All patients achieved the expected correction. IMD and mLDFA were significatively improved. Only one patient presents a minor perioperative complication.

DISCUSSION

Lateral distal femoral hemiepiphysiodesis with screws and nonabsorbable filament resulted to be an effective alternative for genu valgum gradual correction in pediatric population. This is the first article that proposes this model, as an efficient and simple alternative for the treatment of genu valgum in pediatric patients.

LEVEL OF EVIDENCE

Retrospective study, Level IV.

摘要

引言

存在多种用于下肢角状畸形逐步矫正的技术。在新西兰兔中,螺钉和不可吸收丝线已被描述为暂时性半骺阻滞的一种有效替代方法。

假设

使用螺钉和不可吸收丝线进行半骺阻滞在儿科人群中对于膝外翻的矫正有效。

方法

回顾性评估,6例15岁以下患者(3例女性)的12个膝关节,因膝外翻接受手术。采用一种锚固系统,由两枚4.0毫米的松质骨螺钉和金属垫圈通过2.0号FiberWire丝线连接。比较初始和最终的内踝间距(IMD)以及机械性股骨远端外侧角,记录并发症情况。采用曼-惠特尼检验进行统计学分析,显著性值<0.05。

结果

所有患者均实现了预期矫正。IMD和mLDFA均有显著改善。仅1例患者出现轻微围手术期并发症。

讨论

采用螺钉和不可吸收丝线进行股骨远端外侧半骺阻滞是儿科人群膝外翻逐步矫正的一种有效替代方法。这是第一篇提出该模型作为治疗儿科患者膝外翻的一种有效且简单替代方法的文章。

证据水平

回顾性研究,IV级。

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