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采用单侧外固定器行胫骨外侧渐进性开放截骨术矫正胫骨外翻畸形

Lateral Gradual Opening Osteotomy of the Tibia With Monolateral External Fixator for Correcting the Valgus Deformity of the Tibia.

作者信息

Motta Diego Perez da, Faria José Leonardo Rocha de, Cruz Carolina Muruci, Aguiar Diego Pinheiro, Amaral Marcus Vinicius Galvão, Kropf Leandro Lemgruber, Motta Guilherme Augusto Tapado Araújo da, Cerqueira Fernando Dos Santos, Leonetti Bruno Domenico, Cerqueira Flavio Dos Santos

机构信息

Center for Specialized Care of the Treatment Area of Dysmetry and Deformities of the Locomotor System, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.

Center for Specialized Care of Knee Surgery, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.

出版信息

Arthrosc Tech. 2022 Nov 18;11(12):e2271-e2277. doi: 10.1016/j.eats.2022.08.036. eCollection 2022 Dec.

Abstract

The valgus deformity in the tibia requires correction because it places increased pressure on the lateral compartment of the knee, intensifying the degenerative process. Correction strategies are diverse and depend on patient profile, age, and soft-tissue conditions as well as the orthopaedic surgeon's experience with different surgical materials. Deformity size and location are the primary factors contributing to material and shape choice, whether gradual or acute. The only gradual correction approach involves the use of a monolateral or circular external fixator. This is the only indication for correction in cases of excellent deformity, soft-tissue involvement, and a history of bone infection. This study aimed to present a gradual correction technique for tibial valgus deformity using a monolateral external fixator as well as its postoperative follow-up. This technique has the advantages of greater patient acceptance, lighter assembly, and briefer distraction owing to the use of a single piece as well as the ability of the operated limb to bear a load the day after the surgical procedure and dynamic outpatient follow-up.

摘要

胫骨外翻畸形需要矫正,因为它会增加膝关节外侧间室的压力,加剧退变过程。矫正策略多种多样,取决于患者情况、年龄、软组织状况以及骨科医生对不同手术材料的经验。畸形的大小和位置是决定材料和形状选择的主要因素,无论是采用渐进式还是急性矫正方式。唯一的渐进矫正方法是使用单侧或环形外固定器。这是畸形严重、伴有软组织问题和有骨感染病史的病例中唯一的矫正指征。本研究旨在介绍一种使用单侧外固定器对胫骨外翻畸形进行渐进矫正的技术及其术后随访情况。该技术具有患者接受度更高、装置更轻便、由于使用单件而牵引时间更短的优点,以及手术肢体在术后次日即可负重和进行动态门诊随访的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a1/9827065/6e46a25db456/gr1.jpg

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