Hessmann M, Gotzen L, Baumgaertel F
Department of Trauma Surgery, Philipps-University Marburg, Germany.
Acta Chir Belg. 1996 Jun;96(3):123-7.
The operative fusion of the knee joint remains a valuable technique in posttraumatic and infectious destruction of the knee. External fixation is the technique of choice. Due to the benefits of the monofixator in regard to stability, limited damage of soft tissues and high patient comfort, arthrodesis of the knee joint using an anteriorly placed unilateral external fixator is the procedure routinely used at our institution. From 1985 to 1994, 19 knee arthrodesis procedures were performed with a monofixator. Indications for operative fusion of the knee were an infectious destruction of the joint following osteosynthesis (tibial plateau) in 12 cases, posttraumatic arthrosis of the knee joint with chronic infection in 4 cases, flexion ankylosis of the knee in 1 patient, and destructive osteoarthritis of the knee complicated by an empyema in one case. In one patient, a rearthrodesis was performed for a non-union, following an arthrodesis attempt for infected knee arthroplasty. In all cases, stable fusion of the knee joint in a correct position with complete eradication of infection was obtained. Mean fixation time was 22 weeks. The fixator did not need to be removed prematurely.
膝关节手术融合术在膝关节创伤后及感染性破坏中仍是一项有价值的技术。外固定是首选技术。由于单平面外固定器在稳定性、软组织损伤有限及患者舒适度高等方面具有优势，使用前方单侧外固定器进行膝关节融合术是我们机构常规采用的手术方法。1985年至1994年期间，采用单平面外固定器进行了19例膝关节融合手术。膝关节手术融合的适应证包括：12例在接骨术（胫骨平台）后发生的关节感染性破坏；4例膝关节创伤后关节炎伴慢性感染；1例膝关节屈曲性强直；1例膝关节破坏性骨关节炎并发脓胸。1例患者在尝试对感染性膝关节置换术进行关节融合术后因骨不连而行再次关节融合术。所有病例均在正确位置获得了膝关节的稳定融合，感染被彻底根除。平均固定时间为22周。固定器无需过早拆除。
