计算机辅助膝关节内外翻畸形个体化矫形  

Computer Assisted Surgery and Personal Orthopaedy of Patient with Knee Varus and Valgus

作　　者：郝运[1] 何金鹏[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030 [2]华中科技大学同济医学院附属同济医院小儿外科,武汉430030

出　　处：《CT理论与应用研究（中英文）》2016年第4期393-401,共9页Computerized Tomography Theory and Applications

基　　金：同济医院院拨科研基金(2015B015)

摘　　要：目的：探讨计算机辅助膝关节内外翻畸形分析和精确矫形的新方法，评价计算机辅助技术在膝内外翻畸形治疗中的价值。方法：2010年9月至2013年9月共收治膝内外翻畸形患者14例16膝；膝内翻8例10膝，膝外翻 6 例 6膝。术前根据计算机辅助测量结果，选择合适的截骨部位、截骨角度，通过 e-PAC 2000影像工作站设计个性化辅助截骨模板，最后采用计算机模拟设计膝关节内外翻畸形的精确截骨和矫形的手术过程，术中根据计算机辅助模拟的手术方案截骨矫形，HSS 评分标准评定术前术后的膝关节功能，术后复用 e-PAC2000影像工作站评价矫形效果。结果：所有患者均得到随访，随访时间3～12个月，术后早期复用 e-PAC 2000影像工作站证实：膝内外翻畸形完全矫正，下肢负重力线恢复正常。根据膝关节 HSS 评分标准：术前（52.6±13.1）分，术后（86.2±8.9）分，传统方法组与计算机辅助矫形组相比，术后矫形效果确切。随访期间未发现有内固定失败，骨不愈合，膝内外翻复发，无神经血管损伤等并发症，其中1例患者术后2周出现感染，给予伤口清创及置管冲洗引流加换药治疗后好转，随访期间未发现骨不愈合。结论：采用计算机辅助膝内外翻分析和精确矫，将膝内外翻畸形的精确矫形提升到数字化水平，具有更精确，更可靠、更良好的治疗效果。Purpose： To explore a novel method of accurate measurement of patient with knee varus and valgus though computer assistant and the value been evaluated. Method： 14 patients admitted from Sep, 2010 to Sep, 2013, included 16 knees, consisted of 10 varus knees and 6 valgus knees. With computer assisted, appropriate osteotomy site and angle were selected and operation method planned. After operation, HSS evaluation was done compared with those scores before operation. Result： All patients were followed up between 3 to 12 months, the varus and valgus angle were quite well corrected, and the lower limb power lines were rebuilt. HSS scores were elevated from 52.6 ±13.1 to 86.2 ±8.9, respectively. Only 1 patient found infected, and cured with antibiotics. Conclusion： It is a valuable method to help a surgeon to make an operation plan for patients with knee varus and valgus diseases.

关 键 词：膝内外翻畸形 截骨术 计算机辅助 个体化矫形 

分 类 号：R687.4[医药卫生—骨科学] R816.8[医药卫生—外科学]