Icahn School of Medicine at Mount Sinai, New York, New York.
JBJS Case Connect. 2023 Aug 9;13(3). doi: 10.2106/JBJS.CC.23.00072. eCollection 2023 Jul 1.
Here, we describe a case of a 49-year-old female patient with a history of hypertension and polysubstance use disorder presenting with a distal tibial metaphyseal malunion treated with a clamshell osteotomy. Her follow-up was 2.5 years long.
Malunions in the tibial diaphysis and distal metaphysis can cause significantly increased joint reaction forces and altered gait mechanics leading to cosmetic dissatisfaction and decreased quality of life for these patients. Correction of these deformities can improve patient satisfaction and quality of life, along with decrease the risk of early arthritis. The clamshell osteotomy, although initially described to treat diaphyseal long bone malunions, can safely be performed for treatment of complex periarticular metaphyseal malunions.
本病例报告了一位 49 岁女性患者，有高血压和多种物质使用障碍病史，表现为胫骨骨干骺端愈合不良，采用贝壳式切开术治疗。随访时间为 2.5 年。
胫骨骨干和干骺端愈合不良会导致关节反应力显著增加和步态力学改变，从而导致这些患者的美容满意度下降和生活质量降低。纠正这些畸形可以提高患者的满意度和生活质量，同时降低早期关节炎的风险。贝壳式切开术最初是为治疗骨干长骨愈合不良而描述的，现在可以安全地用于治疗复杂的关节周围骺端愈合不良。
