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焦点穹顶截骨术治疗下肢骨干畸形愈合。

Focal Dome Osteotomy for the Treatment of Diaphyseal Malunion of the Lower Extremity.

机构信息

Orthopedic Trauma Surgeons of Northern California, Carmichael, CA 95608, USA.

出版信息

Medicina (Kaunas). 2022 Feb 17;58(2):308. doi: 10.3390/medicina58020308.

DOI:10.3390/medicina58020308
PMID:35208632
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8874577/
Abstract

The treatment of malunion of the lower extremity diaphysis is challenging. Diaphyseal osteotomies require extra care to promote bone healing. This may be enhanced through osteotomies, which do not produce bone gaps and allow for compression. The focal dome osteotomy allows for rotation around an axis to correct angular deformity. The production of a successful arcuate or focal dome osteotomy requires a suitable soft tissue host. The deformity analysis is not complex but essential to assess the feasibility of correction and is required for perfect execution of the osteotomy. This tutorial explains the technique for focal dome osteotomy to correct angular deformities of the lower extremities, specifically in the diaphysis. Surgical correction for malunion, infected malunion, and infected mal-nonunion case examples are discussed. With meticulous planning and surgical technique, the focal dome osteotomy is a viable option for correcting diaphyseal malunions with compression techniques that allow a stable construct for early weight-bearing.

摘要

下肢骨干畸形愈合的治疗颇具挑战。骨干切开术需要格外小心以促进骨愈合。通过不会产生骨间隙且允许加压的截骨术可以增强愈合。病灶穹隆截骨术可围绕轴进行旋转以矫正成角畸形。成功施行弧形或病灶穹隆截骨术需要合适的软组织床。畸形分析并不复杂，但对于评估矫正的可行性至关重要，也是完美施行截骨术所必需的。本教程介绍了通过病灶穹隆截骨术矫正下肢骨干成角畸形的技术，特别是骨干的。讨论了畸形愈合、感染性畸形愈合和感染性畸形不愈合病例的手术矫正。通过精心的规划和手术技术，病灶穹隆截骨术是一种可行的选择，可采用加压技术矫正骨干畸形愈合，为早期负重提供稳定的结构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/d0e781d63dff/medicina-58-00308-g009a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/e1b60c6b18af/medicina-58-00308-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/eaa8185c2705/medicina-58-00308-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/fac17fd8a7f4/medicina-58-00308-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/e46ee3850b25/medicina-58-00308-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/8afdc4410b09/medicina-58-00308-g005a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/5201d09c4103/medicina-58-00308-g006a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/27c4fb0a0b47/medicina-58-00308-g007a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/aa4e8bdcf154/medicina-58-00308-g008a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/d0e781d63dff/medicina-58-00308-g009a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/e1b60c6b18af/medicina-58-00308-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/eaa8185c2705/medicina-58-00308-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/fac17fd8a7f4/medicina-58-00308-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/e46ee3850b25/medicina-58-00308-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/8afdc4410b09/medicina-58-00308-g005a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/5201d09c4103/medicina-58-00308-g006a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/27c4fb0a0b47/medicina-58-00308-g007a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/aa4e8bdcf154/medicina-58-00308-g008a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3257/8874577/d0e781d63dff/medicina-58-00308-g009a.jpg

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[1]
Focal Dome Osteotomy for the Treatment of Diaphyseal Malunion of the Lower Extremity.

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引用本文的文献

[1]
Comparative analysis of closed reduction with external fixation versus closed reduction with percutaneous pinning for distal radius fractures.

Sci Rep. 2025-5-31

[2]
Osteotomies: Indications, Imaging Appearance, Surgical Techniques, and Complications.

Diagnostics (Basel). 2025-5-8

[3]
Outcome of Deformity Correction of Malunited Fracture of the Tibia: An Uncommon Case Report.

J Orthop Case Rep. 2025-5

[4]
Focal Dome Osteotomy Combined with Ilizarov Technique for Treating Femoral Multiplanar Deformity.

Orthop Surg. 2024-9

[5]
Dome versus single-cut osteotomies for correction of long bone deformities-technical considerations.

Sci Rep. 2024-6-4

[6]
New insights in lower limb reconstruction strategies.

Ther Adv Musculoskelet Dis. 2023-7-29

本文引用的文献

[1]
The Clamshell Osteotomy for Diaphyseal Malunion in Deformity Correction and Fracture Surgery.

Medicina (Kaunas). 2021-9-10

[2]
Concave-convex Reaming of Intercalary Allograft: 1-year Clinical Outcomes.

J Am Acad Orthop Surg Glob Res Rev. 2021-4-20

[3]
Reverse-reamed Intercalary Allograft: A Surgical Technique.

J Am Acad Orthop Surg. 2018-7-15

[4]
The history, evolution and basic science of osteotomy techniques.

Strategies Trauma Limb Reconstr. 2017-11

[5]
Femoral supracondylar focal dome osteotomy with plate fixation for acute correction of frontal plane knee deformity.

Strategies Trauma Limb Reconstr. 2015-4

[6]
Diaphyseal osteotomy after post-traumatic malalignment.

Curr Rev Musculoskelet Med. 2014-12

[7]
An innovative approach to concave-convex allograft junctions: a biomechanical study.

Am J Orthop (Belle Mead NJ). 2012-5

[8]
Complications of closing wedge high tibial osteotomy.

Int Orthop. 2009-6-24

[9]
The clamshell osteotomy: a new technique to correct complex diaphyseal malunions.

J Bone Joint Surg Am. 2009-2

[10]
Inhibition of fracture healing.

J Bone Joint Surg Br. 2007-12

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