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踝关节骨折后出现进行性外翻畸形患者的腓骨延长截骨术

Fibular-Lengthening Osteotomy in Patient with Progressive Valgus Deformity After an Ankle Fracture.

作者信息

Gómez-Palomo Juan Miguel, Martínez-Crespo Ana, Rodríguez-Delourme Inés, García-Pérez Juan Ramón, Martínez-Espinosa Miguel, Montañez-Heredia Elvira

机构信息

Department of Orthopedic Surgery and Traumatology, Virgen de la Victoria University Hospital, Málaga, Spain.

Biomedical Research Institute of Malaga (IBIMA), Virgen de la Victoria University Hospital, Málaga, Spain.

出版信息

Am J Case Rep. 2020 Feb 12;21:e920460. doi: 10.12659/AJCR.920460.

DOI:10.12659/AJCR.920460
PMID:32047142
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7038640/
Abstract

BACKGROUND The fibular fracture requires an anatomical reduction. When a malunion occurs, it can lead to a valgus deformity with an opening of the ankle mortise. CASE REPORT This case deals with a 23-year-old patient with pain and limited movement in the right ankle, caused by a fracture healed in an incorrect position, with shortening of the fibula and progressive displacement of the valgus, after surgery 12 months earlier for an ankle fracture. The patient underwent a corrective procedure consisting of extemporaneous lengthening of the fibula, with interposition of autologous bone graft and fixation using a compression plate. Six months after surgery, the patient did not present pain or limited movement, and was able to return to his habitual sporting activity. CONCLUSIONS Fibular-lengthening osteotomy is a procedure indicated for patients with malunion fracture of the distal fibula, with shortening and progressive valgus deformity. This surgery allows the restoration of the joint surface, reduces stress on the cartilage and prevents the development of arthropathy of the ankle.

摘要

背景 腓骨骨折需要解剖复位。当发生畸形愈合时，可导致外翻畸形并伴有踝关节 mortise 开口。病例报告 本病例涉及一名23岁患者，其右踝疼痛且活动受限，原因是12个月前因踝关节骨折手术后骨折在不正确位置愈合，伴有腓骨缩短和外翻逐渐移位。患者接受了一项矫正手术，包括腓骨临时延长、自体骨移植植入和使用加压钢板固定。术后6个月，患者无疼痛或活动受限，能够恢复其日常体育活动。结论 腓骨延长截骨术适用于腓骨远端骨折畸形愈合、伴有缩短和逐渐外翻畸形的患者。该手术可恢复关节面，减轻软骨压力并防止踝关节病的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2000/7038640/7bd3dad2e296/amjcaserep-21-e920460-g007.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2000/7038640/7bd3dad2e296/amjcaserep-21-e920460-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2000/7038640/e3b86ca03a7a/amjcaserep-21-e920460-g001.jpg
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本文引用的文献

1
Fibular-Lengthening Osteotomy to Correct a Malunited Ankle Fracture Using Fresh-Frozen Femoral Head Allograft.采用新鲜冷冻同种异体股骨头进行腓骨延长截骨术以矫正踝关节骨折不愈合。
J Am Podiatr Med Assoc. 2017 Jul;107(4):318-323. doi: 10.7547/15-207.
2
Acute syndesmotic instability in ankle fractures: A review.踝关节骨折中的急性下胫腓联合不稳定：综述
Foot Ankle Surg. 2017 Sep;23(3):135-141. doi: 10.1016/j.fas.2016.04.001. Epub 2016 Apr 25.
3
Fibular Lengthening Using the Elongated Combi-hole of a Locking Compression Plate: Technical Tip.
使用锁定加压接骨板延长组合孔进行腓骨延长：技术要点
Foot Ankle Int. 2015 Sep;36(9):1104-9. doi: 10.1177/1071100715584847. Epub 2015 Apr 28.
4
Staged reconstruction of a multiplane post-traumatic deformity: a case report.多平面创伤后畸形的分期重建：病例报告
J Foot Ankle Surg. 2014 Jul-Aug;53(4):456-65. doi: 10.1053/j.jfas.2014.03.013. Epub 2014 May 3.
5
Realignment-lengthening osteotomy for malunited distal fibular fracture.腓骨陈旧性骨折不愈合的再复位-延长截骨术。
Int Orthop. 2013 Jul;37(7):1285-90. doi: 10.1007/s00264-013-1876-7. Epub 2013 Apr 9.
6
Fibular lengthening using distraction osteogenesis for the treatment of fibular malunion: a case report.采用牵张成骨技术行腓骨延长术治疗腓骨骨不连：1例病例报告
Foot Ankle Int. 2013 Jul;34(7):1035-9. doi: 10.1177/1071100713479585. Epub 2013 Feb 27.
7
Using a cervical spine cage to reconstruct malunited fibular fractures.使用颈椎 cage 重建愈合不良的腓骨骨折。
Int Orthop. 2013 Mar;37(3):447-50. doi: 10.1007/s00264-012-1745-9. Epub 2013 Jan 17.
8
Distal fibular lengthening after premature growth arrest: a case report.过早生长停滞后腓骨远端延长：一例报告
J Orthop Surg (Hong Kong). 2012 Dec;20(3):409-13. doi: 10.1177/230949901202000332.
9
Lengthening z-osteotomy of the fibula to correct persistent talar shift following open reduction internal fixation of ankle fractures.腓骨延长Z形截骨术用于纠正踝关节骨折切开复位内固定术后持续的距骨移位。
Foot Ankle Spec. 2012 Apr;5(2):107-10. doi: 10.1177/1938640011434509. Epub 2012 Jan 31.
10
Autogenous bone graft: donor sites and techniques.自体骨移植：供骨部位和技术。
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