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高位胫骨截骨术的神经并发症——腓骨截骨术作为一个致病因素：一项临床与解剖学研究

Neurological complications of high tibial osteotomy--the fibular osteotomy as a causative factor: a clinical and anatomical study.

作者信息

Wootton J R, Ashworth M J, MacLaren C A

机构信息

Robert Jones and Agnes Hunt Hospital, Oswestry.

出版信息

Ann R Coll Surg Engl. 1995 Jan;77(1):31-4.

PMID:7717642
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2502526/
Abstract

A clinical study of 105 upper tibial osteotomies was undertaken to investigate the incidence, pathology and outcome of perioperative neurological deficit. Motor weakness and/or sensory deficit occurred in 21 patients (20%) and in half of these the deficit was permanent. For descriptive purposes the fibula was divided into four zones. The occurrence of a neurological deficit was clearly related to the level of the fibular osteotomy. An anatomical explanation is proposed for this complication, based on cadaveric studies. Due to unacceptably high levels of complications it is recommended that the fibular osteotomy should not be performed in zones II and III (from just below the fibular head to 15 cm distal to this level).

摘要

对105例胫骨上段截骨术进行了一项临床研究，以调查围手术期神经功能缺损的发生率、病理情况及结局。21例患者（20%）出现运动无力和/或感觉缺损，其中半数患者的缺损为永久性。为便于描述，将腓骨分为四个区域。神经功能缺损的发生与腓骨截骨的水平明显相关。基于尸体研究，对这一并发症提出了一种解剖学解释。由于并发症发生率高得令人无法接受，建议不要在II区和III区（从腓骨头下方至该水平远端15厘米处）进行腓骨截骨术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d4f/2502526/bdbfe4c49bb4/annrcse01593-0043-c.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d4f/2502526/4442bc149b7a/annrcse01593-0043-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d4f/2502526/55da8bff1018/annrcse01593-0043-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d4f/2502526/bdbfe4c49bb4/annrcse01593-0043-c.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d4f/2502526/4442bc149b7a/annrcse01593-0043-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d4f/2502526/55da8bff1018/annrcse01593-0043-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d4f/2502526/bdbfe4c49bb4/annrcse01593-0043-c.jpg

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OSTEOTOMY OF THE UPPER PORTION OF THE TIBIA FOR DEGENERATIVE ARTHRITIS OF THE KNEE. A PRELIMINARY REPORT.胫骨上段截骨术治疗膝关节退行性关节炎。初步报告。
J Bone Joint Surg Am. 1965 Jul;47:984-90.
2
Tibial osteotomy for osteoarthritis of the knee.膝关节骨关节炎的胫骨截骨术
Acta Orthop Belg. 1982 Jan-Feb;48(1):93-6.
3
The technique and complications of upper tibial osteotomy. A review of 226 operations.胫骨上段截骨术的技术与并发症。226例手术回顾
Comparison of Proximal Tibiofibular Joint Detachment with Tibial-Sided Osteotomy for Fibular Untethering in Lateral Closing-Wedge High Tibial Osteotomy: A Cadaveric Study.
外侧闭合楔形高位胫骨截骨术中近端胫腓关节分离与胫骨侧截骨行腓骨松解的比较：一项尸体研究
Medicina (Kaunas). 2025 Jan 19;61(1):161. doi: 10.3390/medicina61010161.
4
The Effectiveness and Safety of Tibial-Sided Osteotomy for Fibula Untethering in Lateral Close-Wedge High Tibial Osteotomy: A Novel Technique with Video Illustration.外侧闭合楔形高位胫骨截骨术中腓骨松解的胫骨侧截骨术的有效性和安全性：一种配有视频演示的新技术
Medicina (Kaunas). 2025 Jan 8;61(1):91. doi: 10.3390/medicina61010091.
5
Lateral closing wedge high-tibial osteotomy is a long-lasting option for patients under the age of 55 with medial compartment osteoarthritis.外侧闭合楔形高位胫骨截骨术是55岁以下内侧间室骨关节炎患者的一种长期治疗选择。
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