van Heerwaarden Ronald, Brinkman Justus-Martijn, Pronk Yvette
Centre for Deformity Correction and Joint Preserving Surgery, Kliniek ViaSana, Mill, The Netherlands.
Research Department, Kliniek ViaSana, Mill, The Netherlands.
J Knee Surg. 2017 Oct;30(8):746-755. doi: 10.1055/s-0037-1602138. Epub 2017 May 5.
In the past two decades, the insights in the causes and development of valgus leg deformities as well as the options for treatment with corrective osteotomies have dramatically changed. New definitions for deformity analysis and planning for corrections have better defined the patients suitable for femoral valgus deformity corrections. Biomechanical research on new osteotomy methods and stability of plate fixation have provided scientific background for the development of improved surgical techniques that are more accurate, safer, and provide for quicker rehabilitation and bone healing. This article provides an overview of the basic principles behind the correction of femoral valgus deformity. Both the analysis and planning of femoral valgus deformity correction as well as the results of systematic clinical reviews are provided. The current recommended surgical technique of biplanar medial closing-wedge supracondylar osteotomy is explained, and the first clinical results are reported. Finally, the authors describe some of the future directions and needs for treatment optimization of patients with femoral valgus deformity.
在过去二十年中,人们对膝外翻畸形的病因、发展以及截骨矫正治疗方案的认识发生了巨大变化。畸形分析和矫正规划的新定义更好地明确了适合进行股骨外翻畸形矫正的患者。关于新截骨方法和钢板固定稳定性的生物力学研究为改进手术技术的发展提供了科学依据,这些技术更精确、更安全,能实现更快的康复和骨愈合。本文概述了股骨外翻畸形矫正背后的基本原则。文中提供了股骨外翻畸形矫正的分析与规划以及系统临床综述的结果。阐述了当前推荐的双平面内侧闭合楔形髁上截骨手术技术,并报告了首批临床结果。最后,作者描述了股骨外翻畸形患者治疗优化的一些未来方向和需求。