Ming Tan Shi, Koon Wong Merng
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
J Orthop Case Rep. 2016 Jul-Aug;6(3):91-93. doi: 10.13107/jocr.2250-0685.530.
Uni-compartmental knee arthritis may be treated with several surgical options including uni-compartmental knee arthroplasty, total knee arthroplasty and high tibial osteotomy. Non-union is a well-established and common complication that may arise from the latter option and few reports have shown successful treatment of persistent non-union of high tibial osteotomy.
We present a case of persistent non-union after high tibial osteotomy treated with autologous iliac crest bone grafting and revision plating. At 1 year post-operative interval, successful union was achieved after revision internal fixation. In addition, a good functional outcome was achieved.
In this patient with persistent non-union following high tibial osteotomy, the aim of revision was to restore alignment and effect bone healing while preserving adequate tibial bone stock. Revision plating with autologous bone grafting is a good surgical strategy in the treatment ofpersistent non-union with hardware failure.
单髁膝关节关节炎可通过多种手术方式治疗,包括单髁膝关节置换术、全膝关节置换术和高位胫骨截骨术。骨不连是后一种手术方式可能出现的一种公认且常见的并发症,很少有报告显示成功治疗高位胫骨截骨术后持续骨不连的情况。
我们报告一例高位胫骨截骨术后持续骨不连的病例,采用自体髂嵴植骨和翻修钢板固定治疗。术后1年随访时,翻修内固定术后实现了成功愈合。此外,还取得了良好的功能结果。
对于该高位胫骨截骨术后持续骨不连的患者,翻修的目的是恢复对线并促进骨愈合,同时保留足够的胫骨骨量。自体骨移植翻修钢板固定是治疗伴有内固定失败的持续骨不连的一种良好手术策略。