Aly Ahmad Saeed, Abdelhamid Alsabir Ahmed Refaat, Fahmy Hesham Ahmad, Fayyad Tamer A
Ain Shams University, Heliopolis, Cairo, Egypt.
J Child Orthop. 2021 Feb 1;15(1):6-11. doi: 10.1302/1863-2548.15.200097.
To assess the reliability and efficacy of the modified oblique high tibial osteotomy for correction of complex deformity in adolescent tibia vara.
A total of 19 patients (25 legs) with adolescent tibia vara were enrolled in this study. There were 16 male (84.2%) and three female (15.8%) patients who had modified Rab oblique osteotomy with minimal fixation performed. The age of the patients at time of surgery ranged from 12 years to 30 years (mean 17.23 (sd 5.27)). The body mass index ranged from 22 kg/m to 42 kg/m (mean 32.05 (sd 6.13)). All patients were followed up for over two years (mean 3.4; 2 to 5).
The femoro-tibial angle was improved from -34° to -12° (mean -20.04° (sd 5.24°) preoperatively and from -12° to 7°, postoperatively (mean 2.04° (sd 4.07)). Medial deviation of the mechanical axis corrected from 38 mm to 125 mm (mean 76.13 (sd 23.29)) preoperatively to 0 mm to 36 mm (mean 5.74 (sd 7.3)) postoperatively. The time needed to achieve union ranged from eight weeks to 16 weeks (mean 10.2 (sd 2.42)). According to the Lysholm functional knee score scale, there were 15 excellent (78.9%), two good (10.5%), one fair (5.2%) and one poor (5.2%) after correction of the deformity.
Modified Rab osteotomy with minimal fixation by two or three screws shows promising results with good correction of varus deformity (coronal plane), internal torsion (axial plane) and procurvatum (sagittal plane), in management of adolescent tibia vara with minimal morbidity and complications.
IV.
评估改良斜行高位胫骨截骨术矫正青少年胫骨内翻复杂畸形的可靠性和疗效。
本研究共纳入19例（25条腿）青少年胫骨内翻患者。其中男性16例（84.2%），女性3例（15.8%），均接受了改良Rab斜行截骨术并采用了最小化固定。手术时患者年龄为12岁至30岁（平均17.23岁（标准差5.27））。体重指数范围为22kg/m至42kg/m（平均32.05（标准差6.13））。所有患者均随访超过两年（平均3.4年；2至5年）。
股骨-胫骨角术前从-34°改善至-12°（平均-20.04°（标准差5.24°）），术后从-12°改善至7°（平均2.04°（标准差4.07））。机械轴内翻偏移术前从38mm矫正至125mm（平均76.13（标准差23.29）），术后从0mm至36mm（平均5.74（标准差7.3））。达到骨愈合所需时间为8周至16周（平均10.2周（标准差2.42））。根据Lysholm膝关节功能评分量表，畸形矫正后，优15例（78.9%），良2例（10.5%），可1例（5.2%），差1例（5.2%）。
采用两三枚螺钉进行最小化固定的改良Rab截骨术在治疗青少年胫骨内翻时，在矫正内翻畸形（冠状面）、内旋（轴面）和前凸（矢状面）方面显示出良好效果，且发病率和并发症最低。
IV级。
