全膝关节置换术联合胫骨截骨术治疗胫骨平台骨折畸形愈合后伴发的膝关节骨关节炎：一例报告
Total knee arthroplasty with corrective osteotomy for knee osteoarthritis associated with malunion after tibial plateau fracture: a case report.
作者信息
Hosokawa Toshihiro, Arai Yuji, Nakagawa Shuji, Kubo Toshikazu
机构信息
Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
出版信息
BMC Res Notes. 2017 Jun 26;10(1):223. doi: 10.1186/s13104-017-2553-5.
BACKGROUND
When surgeons perform total knee arthroplasty in patients with knee osteoarthritis due to malunion following fractures around the knee joint, corrective osteotomy is recommended for severe deformities. Most such deformities are coronal plane varus or valgus deformities, and reports of sagittal plane flexion or extension deformities are rare. We describe a case in which a one-stage total knee arthroplasty was performed with extension corrective osteotomy in the sagittal plane.
CASE PRESENTATION
A 71-year-old Japanese man presented with left knee pain. He had knee osteoarthritis associated with malunion after a tibial plateau fracture. Plain radiography showed a varus deformity in the coronal plane and a marked flexion deformity in the sagittal plane. We performed total knee arthroplasty concurrently with extension corrective osteotomy using a long stem. Full weight bearing was permitted at 6 weeks postoperatively, and the patient was able to walk without assistance.
CONCLUSIONS
This surgical method appears to be beneficial for shortening the duration of treatment and improving knee function.
背景
当外科医生对膝关节周围骨折畸形愈合导致的膝关节骨关节炎患者进行全膝关节置换术时，对于严重畸形建议进行截骨矫正。大多数此类畸形为冠状面内翻或外翻畸形，矢状面屈曲或伸展畸形的报道很少。我们描述了一例在矢状面进行伸展截骨矫正的一期全膝关节置换术病例。
病例报告
一名71岁的日本男性因左膝疼痛就诊。他在胫骨平台骨折后出现膝关节骨关节炎并伴有畸形愈合。X线平片显示冠状面内翻畸形和矢状面明显的屈曲畸形。我们使用长柄假体同时进行全膝关节置换术和伸展截骨矫正。术后6周允许完全负重，患者能够独立行走。
结论
这种手术方法似乎有利于缩短治疗时间并改善膝关节功能。
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