Middleton S, Walker R W, Norton M
Department of Trauma and Orthopaedics, Royal Cornwall Hospital, Penventinnie Lane, Truro, Cornwall, TR1 3LJ, UK.
Eur J Orthop Surg Traumatol. 2018 Jan;28(1):117-120. doi: 10.1007/s00590-017-2008-7. Epub 2017 Jun 28.
To review patients that have undergone correction of a symptomatic femoral malunion using osteotomy combined with decortication.
A retrospective review of all patients who have undergone decortication and multiplanar osteotomy, looking at the pre-operative deformity, correction achieved, time to union and complications.
Seven patients underwent correction under the senior author from 2003 to 2012. Average age was 46 years (range 32-60 years). All had femoral shortening deformity (average 2.7 cm, range 2-4 cm). Each also had at least one other plane of deformity with rotation being the next most commonly encountered in 5 out of the 7 (average 33°, range 0°-45°). Two had tri-planar deformity with the five having bi-planar deformity. Average time to union was 16.3 months (range 7-39 months) with an average of 1.5 operations (range 1-3 operations) to union. One patient has a non-union after five corrective operations.
Correction of multiplanar deformity of the femur is challenging. Osteotomy with decortication provides a technique to achieve significant femoral multiplanar deformity correction in a single operation. This publication provides technical description of the operative technique, guidance and results.
回顾采用截骨术联合骨皮质剥除术矫正有症状的股骨畸形愈合患者的情况。
对所有接受骨皮质剥除术和多平面截骨术的患者进行回顾性研究，观察术前畸形、矫正效果、愈合时间及并发症。
2003年至2012年，资深作者共为7例患者实施了矫正手术。平均年龄46岁（范围32 - 60岁）。所有患者均有股骨短缩畸形（平均2.7厘米，范围2 - 4厘米）。每位患者还至少有一个其他平面的畸形，其中5例（共7例）其次常见的是旋转畸形（平均33°，范围0° - 45°）。2例为三平面畸形，5例为双平面畸形。平均愈合时间为16.3个月（范围7 - 39个月），平均愈合需1.5次手术（范围1 - 3次手术）。1例患者在5次矫正手术后出现骨不连。
股骨多平面畸形的矫正具有挑战性。截骨术联合骨皮质剥除术提供了一种在单次手术中实现显著股骨多平面畸形矫正的技术。本出版物提供了手术技术的详细描述、指导及结果。
