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交锁式开放楔形胫骨结节远端截骨术:无需辅助螺钉固定的后结节稳定技术

Interlocking Open-Wedge Distal Tibial Tuberosity Osteotomy: Stabilizing Technique in the Retro-Tubercle Without Complementary Screw Fixation.

作者信息

Akasaki Yukio, Horikawa Tomohiro, Hamai Satoshi, Kawahara Shinya, Sato Taishi, Nakashima Yasuharu

机构信息

Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.

Department of Orthoopaedic Surgery, National Hospital Organization Kumamoto Saishun Medical Center, Koshi Kumamoto, Japan.

出版信息

Arthrosc Tech. 2024 Feb 16;13(5):102939. doi: 10.1016/j.eats.2024.102939. eCollection 2024 May.

Abstract

We present a knee osteotomy procedure that we have termed the interlocking open-wedge distal tibial tuberosity osteotomy. In this context, the term pertains to the manner in which the repositioned segments of the retro-tubercle seamlessly fit together as the transverse osteotomy opens to the intended corrective angle. This interlocking mechanism, serving as a distinctive feature, engenders a stable retro-tubercle configuration resembling a mortise-and-tenon joint. The distal end of the tibial tuberosity fits snugly behind the tibial diaphysis, augmenting stability and promoting the healing process. Consequently, poor union of the retro-tubercle caused by the widening of the retro-tubercle gap and an increase in posterior tibial slope are effectively prevented. In addition, the need for complementary hardware such as anteroposterior screw fixation, which is used to secure the retro-tubercle during the healing process, is notably eliminated. This elimination not only simplifies the surgical procedure but also eliminates potential complications that could arise from its use.

摘要

我们介绍一种我们称为“交锁式开放楔形胫骨远端结节截骨术”的膝关节截骨手术。在此背景下,该术语涉及当横向截骨打开至预期矫正角度时,后结节重新定位的节段无缝拼接在一起的方式。这种交锁机制作为一个显著特征,产生了一种类似于榫卯关节的稳定后结节结构。胫骨结节的远端紧密贴合在胫骨干后方,增强了稳定性并促进愈合过程。因此,有效地防止了因后结节间隙增宽和胫骨后倾坡度增加导致的后结节愈合不良。此外,显著消除了在愈合过程中用于固定后结节的诸如前后螺钉固定等辅助硬件的需求。这种消除不仅简化了手术过程,还消除了使用该硬件可能产生的潜在并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/896c/11144815/203650d44fce/gr1.jpg

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