Kinzl L, Strecker W
Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Universität Ulm.
Chirurg. 1998 Nov;69(11):1161-6. doi: 10.1007/s001040050553.
Post-traumatic malalignment can occur on one or several planes following fractures in close proximity to the knee joint. In a clinical and radiological analysis of deformities, the frontal, sagittal and longitudinal alignment, as well as differences in femoral or tibial length and torsion, must be taken into account. The location of the correctional osteotomy is usually defined by the center of the angular and torsional deformity. Of decisive importance when choosing the site of the osteotomy are the local quality of bone and the soft tissue envelope, the condition of the articular cartilage in the different compartments of the knee, the stability of ligamentocapsular structures and preexistent deformities of the distal femur and proximal tibia. Therefore, the location of correctional osteotomies must be modified, depending on the individual situation. The appropriate approach and technique must be chosen from the different available operative techniques. Inaccurate planning and inappropriate operative techniques pose severe risks. Specific postoperative complications are compartment syndromes, nerve irritation and infection.
创伤后畸形排列可发生在膝关节附近骨折后的一个或多个平面上。在对畸形进行临床和放射学分析时,必须考虑额状面、矢状面和纵轴排列,以及股骨或胫骨长度和扭转的差异。矫正截骨术的位置通常由角形和扭转畸形的中心确定。选择截骨部位时,具有决定性意义的是局部骨质质量和软组织包膜、膝关节不同间室的关节软骨状况、韧带关节囊结构的稳定性以及股骨远端和胫骨近端先前存在的畸形。因此,矫正截骨术的位置必须根据个体情况进行调整。必须从不同的可用手术技术中选择合适的入路和技术。不准确的规划和不适当的手术技术会带来严重风险。具体的术后并发症包括骨筋膜室综合征、神经刺激和感染。