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用于安全开放式楔形高位胫骨截骨术的哨兵线技术

The Sentinel Wires Technique for Safe Open Wedge High Tibial Osteotomy.

作者信息

Gawish Hesham Mohamed, Elghaish Mohamed Abdelmonsef Ibrahim, Aziz Waleed Hamed Hamed Ebrahim, Elfekky Mohamed, Abou Helwo Ahmed Hassan Saad, Waly Ahmed Hassan Taha

机构信息

Department of Orthopedic Surgery and Traumatology, Kafr El-Sheik University, Faculty of Medicine, Kafr El-Sheikh, Egypt.

Orthopedic & Trauma Section, Dubai Academic Health Corporation (Dubai Health), Dubai, UAE.

出版信息

Arthrosc Tech. 2025 May 16;14(7):103591. doi: 10.1016/j.eats.2025.103591. eCollection 2025 Jul.

DOI:10.1016/j.eats.2025.103591
PMID:40822221
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12350230/
Abstract

Open wedge high tibial osteotomy is an effective surgical procedure for the treatment of medial compartment arthritis. Takeuchi described 3 types of lateral hinge fractures that may jeopardize the stability of the osteotomy with undesirable outcomes. In this Technical Note, 3 protective K-wires were implemented to improve lateral hinge resistance to failure.

摘要

开放楔形高位胫骨截骨术是治疗内侧间室关节炎的一种有效手术方法。竹内描述了3种外侧铰链骨折类型，这些骨折可能会危及截骨术的稳定性并导致不良后果。在本技术说明中，采用了3根保护克氏针来提高外侧铰链的抗断裂能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/b490a3e0268f/gr22.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/b490a3e0268f/gr22.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/59decae2c8c6/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/5a8a8eb4a783/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/130ade7119ee/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/03c1650f8587/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/e8355e321714/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/4df9ed294a9b/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/8f436ebb9855/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/1a2575dd9b61/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/e60783a94d3c/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/f68422bcbc39/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/1307f03734d6/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/e57506bd6245/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/6f4383a600c2/gr13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/b61d5a59a477/gr14.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/4accc7585cb5/gr15.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/12ba2fcf1eb8/gr16.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/b2d707abf42b/gr17.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/7a2d4bdbe0a0/gr18.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/53ee641481fd/gr19.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/701f7c18e602/gr20.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/cd94623fe4ba/gr21.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6deb/12350230/b490a3e0268f/gr22.jpg

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本文引用的文献

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Adding a protective screw improves hinge's axial and torsional stability in High Tibial Osteotomy.在胫骨高位截骨术中，增加保护螺钉可提高铰链的轴向和扭转稳定性。
Clin Biomech (Bristol). 2020 Apr;74:96-102. doi: 10.1016/j.clinbiomech.2020.02.015. Epub 2020 Mar 2.
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Biomechanical effect of a lateral hinge fracture for a medial opening wedge high tibial osteotomy: finite element study.内侧开口楔形胫骨高位截骨术横向铰链骨折的生物力学效应：有限元研究。
J Orthop Surg Res. 2020 Feb 21;15(1):63. doi: 10.1186/s13018-020-01597-7.
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Benefits of opposite screw insertion technique in medial open-wedge high tibial osteotomy: A virtual biomechanical study.
内侧开放楔形高位胫骨截骨术中对侧螺钉置入技术的益处：一项虚拟生物力学研究。
J Orthop Translat. 2019 Aug 7;20:31-36. doi: 10.1016/j.jot.2019.06.004. eCollection 2020 Jan.
4
A protective hinge wire, intersecting the osteotomy plane, can reduce the occurrence of perioperative hinge fractures in medial opening wedge osteotomy.保护性铰链钢丝，与截骨面相交，可以减少内侧撑开截骨术中铰链骨折的发生。
Knee Surg Sports Traumatol Arthrosc. 2020 Oct;28(10):3173-3182. doi: 10.1007/s00167-019-05806-7. Epub 2019 Nov 26.
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Adding a protective K-wire during opening high tibial osteotomy increases lateral hinge resistance to fracture.在胫骨高位截骨术中增加保护性 K 线可增加外侧铰链抵抗骨折的能力。
Knee Surg Sports Traumatol Arthrosc. 2020 Mar;28(3):751-758. doi: 10.1007/s00167-019-05404-7. Epub 2019 Feb 19.
6
Predictive Factors for and Detection of Lateral Hinge Fractures Following Open Wedge High Tibial Osteotomy: Plain Radiography Versus Computed Tomography.外侧铰链骨折的预测因素及开放楔形胫骨高位截骨术后的检测：平片与 CT 比较。
Arthroscopy. 2018 Nov;34(11):3073-3079. doi: 10.1016/j.arthro.2018.06.041. Epub 2018 Oct 3.
7
A pilot hole does not reduce the strains or risk of fracture to the lateral cortex during and following a medial opening wedge high tibial osteotomy in cadaveric specimens.在尸体标本中进行内侧开放楔形高位胫骨截骨术期间及术后，预钻孔并不能降低外侧皮质的应变或骨折风险。
Bone Joint Res. 2018 Apr 12;7(2):166-172. doi: 10.1302/2046-3758.72.BJR-2017-0337.R1. eCollection 2018 Feb.
8
Appropriate hinge position for prevention of unstable lateral hinge fracture in open wedge high tibial osteotomy.开放楔形高位胫骨截骨术中预防外侧铰链不稳定骨折的合适铰链位置。
Bone Joint J. 2017 Oct;99-B(10):1313-1318. doi: 10.1302/0301-620X.99B10.BJJ-2017-0103.R1.
9
Mechanical strength assessment of a drilled hole in the contralateral cortex at the end of the open wedge for high tibial osteotomy.高位胫骨截骨术开放楔形截骨末端对侧皮质骨钻孔的机械强度评估。
J Exp Orthop. 2017 Dec;4(1):23. doi: 10.1186/s40634-017-0098-0. Epub 2017 Jun 23.
10
Open-wedge high tibial osteotomy: incidence of lateral cortex fractures and influence of fixation device on osteotomy healing.开放楔形高位胫骨截骨术：外侧皮质骨折的发生率及固定装置对截骨愈合的影响
Knee Surg Sports Traumatol Arthrosc. 2017 Mar;25(3):832-837. doi: 10.1007/s00167-015-3730-5. Epub 2015 Aug 8.