腓骨近端截骨术后膝关节三维运动学特征研究  

A research for three dimentional kinematics characteristics of the knee after proximal fibular osteotomy

作　　者：段德胜[1] 陈开放[2] 郭晓东[2] 张攀[3] 张永飞[1] 

机构地区：[1]安阳市第三人民医院骨二科,455000 [2]华中科技大学同济医学院附属协和医院骨科,武汉430022 [3]武汉市中心医院骨科,430014

出　　处：《中华老年骨科与康复电子杂志》2017年第3期162-166,共5页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金(81672158);国家自然科学基金(81371939);国家重点研发计划重点专项(2016YFC1100100)

摘　　要：目的探讨腓骨近端截骨手术前后在平地行走中的三维运动学差异。方法本研究回顾性分析2015年1月至9月河南省安阳市第三人民医院骨科收治的腓骨近端截骨患者7例,男性2例,女性5例,年龄49岁~71岁,平均(61±11)岁,于术后6个月对患者进行步态分析,对比手术前后患者在正常平地行走时股骨相对胫骨的运动学表现。结果所有患者均获得满意随访,平均随访(6.9±0.3)个月。在步态周期内,与术前比较,腓骨近端截骨术后患者的矢状面屈伸运动[术前(18±14)°,术后(27±15)°,t=68.535]、水平面内外旋转运动[术前(6.3±2.1)°,术后(0.8±2.5)°,t=-38.841]以及前后运动[术前(-0.3±0.5)cm,术后(-0.5±0.6)cm,t=4.301]、上下运动[术前(0.02±0.29)cm,术后(-0.14±0.17)cm,t=24.546]、内外移动[术前(-0.3±0.4)cm,术后(-0.7±0.4)cm,t=6.738]均有明显改善(均P<0.05)。结论腓骨近端截骨可明显改善膝关节骨性关节炎患者的运动学表现。Objectives To investigate the differences in three dimentional （3D） kinematics during walking among patients with osteoarthritis before and after proximal fibula osteotomy. Methods A retrospective study was performed on 7 cases of proximal fibula osteotomy in Orthopedics Dept. of the third of Anyang people’s Hospital （2015.1-2015.9）. There were two males and four females with an average age of 61 ± 11 years （49- 71 years）. The kinematics data were collected in 6 m after surgery, rotation and translation of the femur relative to the tibia during normal walking were compared before and after surgery. Results All patients were followed up for 6.9 ± 0.3 months. Significant differences in the 3D knee joint kinematics among the groups were found. Compared with pre- operative motion, the flexion- extension rotation in sagittal plan [pre- operation： （18 ± 14）° , post- operation： （27 ± 15）° , t=68.535], internal- external rotational in horizontal plan [pre-operation：（6.3±2.1）°, post-operation：（0.8±2.5）°, t=-38.841） and anteriorposterior （pre- operation：- 0.3 ± 0.5 cm, post- operation： - 0.5 ± 0.6 cm, t=4.301）, superior- inferior （preoperation： 0.02 ± 0.29 cm, post- operation： - 0.14 ± 0.17 cm, t=24.546）, medial-lateral （pre- operation：- 0.3 ± 0.4 cm, post- operation：- 0.7 ± 0.4 cm, t=6.738） translation during walking after proximal fibula osteotomy were all improved （P〈0.05）. Conclusions Proximal fibula osteotomy can improve the knee motion kinematically in patients with osteoarthritis.

关 键 词：截骨术 膝关节 运动活动 运动分析 

分 类 号：R687.3[医药卫生—骨科学]