Sabo D, Mau H, Bläsius K
Stiftung Orthopädische Universitätsklinik Heidelberg.
Z Orthop Ihre Grenzgeb. 1996 Jan-Feb;134(1):11-5. doi: 10.1055/s-2008-1037411.
Two techniques of closed wedge osteotomy of the proximal tibia in 132 cases using external fixation device were compared retrospectively for neurological complication rate. While in group 1 (n = 89) wedge osteotomy was performed conventionally using an oscillating saw, in group 2 (n = 43) osteotomy was done with consecutive drill holes of increasing diameter followed by osteoclasis. Neurological complications in group 1 were found postoperatively 15.7% (transient) and after 7 months follow-up time in 12.4% (persistent), in group 2 14% transient and 4.7% persistent neurological deficits were registered. The lower complication rate in group 2 is due to the reduction of postoperative tibialis anterior syndrome (type B lesions). No differences for type C lesions (extension deficit of D1) were found. No complete peroneal palsy (type A) occurred in either group. The authors conclude that reduction of neurological complications in group 2 is related to the less extensive approach of the proposed technique.
回顾性比较了使用外固定装置对132例近端胫骨进行闭合楔形截骨术的两种技术的神经并发症发生率。在第1组（n = 89）中，使用摆动锯按常规方法进行楔形截骨术，而在第2组（n = 43）中，通过依次钻出直径递增的钻孔然后进行折骨术来完成截骨术。第1组术后发现神经并发症的发生率为15.7%（短暂性），在7个月的随访期后为12.4%（持续性），第2组记录到的短暂性神经功能缺损为14%，持续性为4.7%。第2组较低的并发症发生率是由于术后胫前综合征（B型病变）减少。未发现C型病变（D1伸展功能障碍）有差异。两组均未发生完全性腓总神经麻痹（A型）。作者得出结论，第2组神经并发症的减少与所提议技术的侵袭性较小有关。
