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使用磁性髓内延长钉进行膝关节延长及畸形矫正

Lengthening and deformity correction about the knee using a magnetic internal lengthening nail.

作者信息

Fragomen Austin T, Rozbruch S Robert

机构信息

Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, USA.

出版信息

SICOT J. 2017;3:25. doi: 10.1051/sicotj/2017014. Epub 2017 Mar 22.

Abstract

INTRODUCTION

The introduction of the internal lengthening nail (ILN) has changed the treatment of complex malalignment and shortening about the knee. Acute correction of the deformity and gradual lengthening through this osteotomy site has greatly simplified postoperative recovery. This manuscript is a review of the techniques that are currently being used in surgery.

METHODS

The article is broken into two sections: distal femur osteotomy and tibia osteotomy. Each is addressed separately since they have different personalities. Also included are topics of particular interest that surface in ongoing conferences regarding the ILN. This work is a mix of expert opinion and best practice supported by peer reviewed publications on the topic.

RESULTS

Most published series demonstrate excellent results with the ILN. Certain precautions are reiterated including avoiding mechanical failure, need for a percutaneous osteotomy, need for over-reaming, and the need for blocking screws.

DISCUSSION

Current controversies will be brought to light and discussed. The reader should find this aspect particularly helpful in navigating this rapidly evolving field.

摘要

引言

髓内延长钉(ILN)的引入改变了膝关节复杂畸形和短缩的治疗方式。通过该截骨部位进行畸形的急性矫正和逐步延长极大地简化了术后恢复过程。本文是对目前手术中所使用技术的综述。

方法

文章分为两个部分:股骨远端截骨和胫骨截骨。由于它们具有不同特点,故分别进行阐述。还包括在关于ILN的 ongoing conferences中出现的特别受关注的话题。这项工作是专家意见与经同行评审的该主题出版物所支持的最佳实践的结合。

结果

大多数已发表的系列研究表明ILN取得了优异的效果。重申了某些注意事项,包括避免机械故障、经皮截骨的必要性、过度扩髓的必要性以及使用阻挡螺钉的必要性。

讨论

当前的争议将被揭示并进行讨论。读者会发现这方面内容在这个快速发展的领域中导航时特别有帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b4/5360097/a15cea237de8/sicotj-3-25-fig1.jpg

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