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采用单侧外固定器行胫骨内侧渐进性开放截骨术矫正胫骨内翻畸形

Medial Gradual Opening Osteotomy of the Tibia With Monolateral External Fixator for Correcting the Varus Deformity of the Tibia.

作者信息

Cerqueira Flavio Dos Santos, Junqueira Felipe Holanda, Vasconcelos Pereira Guilherme Blois, da Silva Larissa, Teixeira Lucas Braga, Maia David Guerci, Vivas Rafael Gouvea de Moraes, Soares de Faria Jander, Rocha de Faria Jose Leonardo, Kropf Leandro Lemgruber, Santos Cerqueira Fernando Dos, Leonetti Bruno Domenico, Motta Diego Perez da

机构信息

National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.

出版信息

Arthrosc Tech. 2024 Jun 14;13(9):103041. doi: 10.1016/j.eats.2024.103041. eCollection 2024 Sep.

Abstract

Correction of the varus deformities in the tibia is necessary because of the excessive pressure exerted on the medial compartment of the knee, which intensifies the degenerative process. Correction strategies encompass a variety of approaches and depend on the patient's individual characteristics, age, soft tissue condition, and the orthopaedic surgeon's experience with different surgical materials. Size and location of the deformity, whether gradual or acute, play crucial roles in choosing the most appropriate material and shape. The gradual correction is especially indicated for patients with severe deformities, soft tissue involvement, and a history of bone infections. This study aimed to introduce a gradual correction technique for varus deformities in the tibia using a unilateral external fixator and to describe the postoperative follow-up. This technique offers notable advantages, including accurate correction, better patient acceptance, lighter assembly, less risk of pseudarthrosis, and shorter distraction process owing to the use of a single piece. In addition, the operated limb can support the load on the day after surgery, and dynamic follow-up is performed on an outpatient basis.

摘要

由于膝关节内侧间室承受的压力过大,会加剧退变过程,因此纠正胫骨内翻畸形很有必要。纠正策略包括多种方法,且取决于患者的个体特征、年龄、软组织状况以及骨科医生使用不同手术材料的经验。畸形的大小和位置,无论是渐进性的还是急性的,在选择最合适的材料和形状方面都起着关键作用。对于严重畸形、软组织受累以及有骨感染病史的患者,尤其适合采用渐进性矫正。本研究旨在介绍一种使用单侧外固定器对胫骨内翻畸形进行渐进性矫正的技术,并描述术后随访情况。该技术具有显著优势,包括精确矫正、患者接受度更高、装置更轻便、假关节风险更低,以及由于使用单件而使牵张过程更短。此外,手术肢体在术后第二天即可承重,并且在门诊进行动态随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bea/11411377/20bb1f5952fd/gr3.jpg

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