楔形截骨单边外固定架矫正膝外翻股骨短缩畸形  

Distal closed wedge osteotomy combined with proximal osteotomy and lengthening with unilateral external fixator for femoral shortening and genu valgus

作　　者：詹晓欢 王朝辉[1] 高峻青[1] 付记乐[1] 李雪[1] 李卓伟[1] 王兮[1] ZHAN Xiao-huan;WANG Zhao-hui;GAO Jun-qing;FU Ji-le;LI Xue;LI Zhuo-wei;WANG Xi(Department of Reparative and Reconstructive Surgery,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]佛山市中医院修复重建外科,广东佛山528000

出　　处：《中国矫形外科杂志》2020年第21期1992-1995,共4页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81601911);广东省科技计划项目(编号:2017B090904002);佛山市十三五医学重点专科建设项目(编号:FSZDZK135019)。

摘　　要：[目的]介绍楔形截骨单边外固定架矫正膝外翻股骨短缩畸形的手术技术与初步结果。[方法]2014年1月~2018年6月,对6例膝外翻合并股骨短缩畸形的患者行手术矫正。采用股骨远端内侧闭合楔形截骨Tomofix钢板固定,结合股骨近端截骨Orthofix单边外固定架牵开延长。[结果]6例患者顺利完成手术,股骨延长部位成骨良好,延长长度(5.25±1.67)cm,外固定支架拆除时间(16.50±2.43)个月,外固定指数(3.38±0.69)个月/cm,钢板拆除时间(19.83±1.72)个月。末次随访时,患肢股胫角、远端股骨外侧角均较术前显著增加(P<0.05)。[结论]股骨远端内侧闭合楔形截骨结合Orthofix单边外固定支架可有效矫治膝外翻合并股骨短缩畸形,提高患者治疗过程中的舒适性。[Objective]To introduce the surgical technique and primary outcomes of distal closed wedge osteotomy combined with proximal osteotomy and lengthening with unilateral external fixator for femoral shortening and genu valgus.[Methods]From January 2014 to June 2018,6 patients with femoral shortening accompanied with genu valgus deformities underwent the surgical corrections.The medial closed wedge osteotomy and internal fixation with Tomofix plate were conducted on the distal femur to correct the genu valgus deformity,followed by proximal osteotomy and distracting femoral lengthening with an unilateral external fixator to correct the shortening deformity.[Results]All the 6 patients had the corrective treatments finished successfully with femoral lengthening of(5.25±1.67)cm,the time to remove the external frame of(16.50±2.43)months,external fixation index of(3.38±0.69)month/cm,and the time to remove internal implant of(19.83±1.72)months.At the latest follow up,the femorotibial angle and lateral angle of distal femur significantly improved in all the 6 patients compared with those before operation(P<0.05).[Conclusion]The distal closed wedge osteotomy combined with proximal osteotomy and lengthening with unilateral external fixator does correct the femoral shortening and genu valgus effectively,with benefit of improving patient’s tolerance during correction.

关 键 词：股骨短缩 膝外翻 闭合楔形截骨 骨延长 

分 类 号：R681.18[医药卫生—骨科学]