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青少年和年轻成人膝外翻V形截骨术后的临床结果及矫正情况:一项系统评价

Clinical outcome and correction following V osteotomy for genu valgum in adolescents and young adults: A systematic review.

作者信息

Choudhary Ranjeet, Kunal Kishor, Sud Alok, Kumar Ramesh, Munde Kishor, Roy Sanchit

机构信息

AIIMS, Raipur, India.

AIIMS, Jodhpur, India.

出版信息

J Clin Orthop Trauma. 2022 Feb 9;26:101803. doi: 10.1016/j.jcot.2022.101803. eCollection 2022 Mar.

Abstract

BACKGROUND

Genu Valgum usually originates from distal femur and many open and closed wedge osteotomies of distal femur have been reported but none has proved to be the best. Distal femur V osteotomy is a wedgeless osteotomy and is a rarely reported osteotomy with only a few case series and 167 cases of isolated distal femur V osteotomy for genus valgum in young patients (<25 years) in literature but with a tendency to have an excellent outcomes.

PURPOSE

To determine correction and clinical outcome following V osteotomy for genu valgum in adolescents and young adults (10-25 years).

PATIENT AND METHODS

A systematic research was conducted of PubMed, MEDLINE and Google Scholar to identify studies reporting the correction and clinical outcome following V osteotomy in adolescents and young adults (10-25 years) for genu valgum by 2 different authors according to PRISMA guidelines.

RESULTS

5 studies with 167 patients and 263 knees were identified meeting the inclusion criteria for review. The follow-up period ranged from 3 months to 36 months. Overall complication rate was 12.3%, the most common being plaster sore, 4.2% (11/263) followed by superficial infection, 2.7% (7/263). The mean correction was 19.1° and a mean post-operative valgus was 5.7°. In those compared with Bostman score (157/167), 94.3% had excellent (148/157) and remaining 5.7% (9/157) had good scores (20-27/30) with none showing poor score (<20/30).

CONCLUSION

V osteotomy is a reliable method of distal femoral osteotomy to attain a good correction with an excellent clinical outcome even with variations of fixation however longer follow-up period are required for better evaluation of recurrence.

摘要

背景

膝外翻通常起源于股骨远端,许多关于股骨远端的开放性和闭合性楔形截骨术已有报道,但尚无一种被证明是最佳的。股骨远端V形截骨术是一种无楔形截骨术,是一种报道较少的截骨术,文献中仅有少数病例系列报道,其中167例为针对年轻患者(<25岁)膝外翻的孤立性股骨远端V形截骨术,但有取得优异结果的趋势。

目的

确定青少年和青年(10 - 25岁)膝外翻患者接受V形截骨术后的矫正情况和临床结果。

患者与方法

根据PRISMA指南,由2位不同作者对PubMed、MEDLINE和谷歌学术进行系统检索,以确定报告青少年和青年(10 - 25岁)膝外翻患者接受V形截骨术后矫正情况和临床结果的研究。

结果

共纳入5项研究,涉及167例患者和263个膝关节,符合纳入标准并可进行综述。随访期为3个月至36个月。总体并发症发生率为12.3%,最常见的是石膏压疮,占4.2%(11/263),其次是浅表感染,占2.7%(7/263)。平均矫正角度为19.1°,术后平均外翻角度为5.7°。与Bostman评分比较的患者中(157/167),94.3%的患者评分为优秀(148/157),其余5.7%(9/157)评分为良好(20 - 27/30),无评分差的患者(<20/30)。

结论

V形截骨术是一种可靠的股骨远端截骨方法,即使固定方式有所不同,也能实现良好的矫正并获得优异的临床结果,但需要更长的随访期以更好地评估复发情况。

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