两种截骨术治疗膝骨关节炎合并膝内翻的比较  

Comparative Study of Two Methods in High Tibial Osteotomy for Osteoarthritis of the knee with Genu Varum

作　　者：周其佳 李来昌 郭雄虎[1] 刘亮[2] 孙月柏[1] 丁克海[1] 左松球 朱宝明[1] 

机构地区：[1]阜宁县人民医院骨科,江苏阜宁224400 [2]上海市杨浦区中心医院骨科,上海200090

出　　处：《实用骨科杂志》2007年第4期210-211,217,共3页Journal of Practical Orthopaedics

摘　　要：目的观察对比两种胫骨高位截骨术治疗膝骨关节炎合并膝内翻畸形的临床疗效。方法分别采用胫骨高位截骨连同腓骨中段截骨和胫骨高位截骨连同腓骨小头截骨纠正膝内翻畸形,术后5年以内及5年以后者按同一标准对其疗效进行评价。结果随访结果按窦宝信标准进行评估。胫骨高位截骨连同腓骨中段截骨5年以内及5年以后随访的优良率分别为84.6%、69.2%;胫骨高位截骨连同腓骨小头截骨5年以内及5年以后随访的优良率分别为81.7%、68.1%。两种手术方法的临床优良率基本相似。胫骨高位截骨连同腓骨小头截骨手术时间、手术切口长度、出血量显著低于胫骨高位截骨连同腓骨中段截骨。结论胫骨高位截骨治疗膝关节骨关节炎合并内翻畸形临床疗效确切,远期疗效有下降趋势。胫骨高位截骨连同腓骨小头截骨具有手术创伤小、出血少、手术时间短、腓深神经损伤发生率低等优点。Objective To observe and compare the results of two high tibial osteotomy for osteoarthritis of knee with varus deformity. Methods The patients were respectively treated by two groups to correct the knee varus deformity. One was high tibial osteotomy together with middle part fibulae osteotomy,the other was high tibial osteotomy together with caput fibulae osteotomy. In the 5 years of the operation or over 5 years,the patients were followed-up according to the same assessment criterion. x^2 test was used to evaluate the final outcome. Results Later results were assessed according to the criterion made by Dou Baoxin. In 5 years or over 5 years ,the excellent and good rate of high tibial osteotomy together with middle part fibulae osteotomy was respectively 84.6% and 62.9% ,high tibial osteotomy together with caput fibulae osteotomy 81.8% and 68.1%. The clinical excellent and good result of two methods was similar with each other. The time of operation was in average shorter in the high tibial osteotomy together with caput fibulae osteotomy than that used in the high tibial osteotomy together with middle part fibulae. The surgical incision was also shorter in the high tibial osteotomy together with caput fibulae osteotomy,and also a smaller amoumt of bleeding as well as smaller occuring injury rate of deep peroneal nerve were observed. Conclusion Curative effect of high tibial osteotomy for osteoarthritis of the knee with genu varum is certitiude. There＇s decline in long curative effect. There＇s much advantage in high tibial osteotomy together with caput fibulae osteotmy,such as little injury,seldom bleeding,brevity operation time and low injurying rate of deep peroneal nerve. It＇s deserved to extend and apply.

关 键 词：膝关节 骨关节炎 胫骨高位截骨术 膝内翻 

分 类 号：R684.3[医药卫生—骨科学]