Walter Sebastian G, Schwering Tobias, Preiss Stefan
Department for Orthopedic Surgery, Lengghalde 2, 8008 Zurich, Switzerland.
J Orthop Case Rep. 2017 Mar-Apr;7(2):33-36. doi: 10.13107/jocr.2250-0685.738.
Achondroplasia is the most common form of dwarfism in humans and is orthopedically characterized by shortened extremities and an exaggerated lumbar lordosis. The surgical challenges are maintenance of axial alignment during limb lengthening as well as joint preservation and alignment restoration.
We present a 46-year-old female suffering from achondroplasia with severe pain in both knees. Severe varus deformities of both femurs and degeneration of both knee joints became apparent on clinical and radiological examination. On each femur, we performed one-staged, lateral closed-wedge osteotomy, and total knee arthroplasty (TKA). Subsequently, the patient was relieved of knee joint pain and gained a greater range of motion.
One-staged valgization osteotomy and concomitant TKA represents a challenging, yet reasonable, surgical solution in axially severe malaligned and joint degenerated patients.
软骨发育不全是人类最常见的侏儒症形式,其骨科特征为四肢缩短和腰椎前凸增大。手术挑战在于肢体延长过程中维持轴向对线以及关节保留和对线恢复。
我们报告一名46岁患有软骨发育不全且双膝剧痛的女性。临床和影像学检查显示双侧股骨严重内翻畸形以及双侧膝关节退变。我们对每侧股骨进行了一期外侧闭合楔形截骨术和全膝关节置换术(TKA)。术后,患者膝关节疼痛缓解,活动范围增大。
一期外翻截骨术联合TKA对于轴向严重对线不良和关节退变的患者而言是一种具有挑战性但合理的手术解决方案。