改良Ilizarov微创胫骨近端截骨钢板内固定在膝关节骨性关节炎合并膝内翻中的应用效果及对内翻矫正情况的影响  

Application effect of modified Ilizarov minimally invasive proximal tibial osteotomy plate internal fixation in knee osteoarthritis with knee varus and its influence on varus correction

作　　者：杨丰 王明明 YANG Feng;WANG Mingming(Orthopaedics Department,Zhouzhi United Hospital,Xi'an 710400;Imaging Center,Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,China)

机构地区：[1]周至联合医院骨科,陕西西安710400 [2]安康市中医医院影像中心,陕西安康725000

出　　处：《临床医学研究与实践》2024年第30期57-60,共4页Clinical Research and Practice

摘　　要：目的探究改良Ilizarov微创胫骨近端截骨钢板内固定在膝关节骨性关节炎合并膝内翻中的应用效果及对内翻矫正情况的影响。方法选择2021年2月至2023年3月接诊的80例膝关节骨性关节炎合并膝内翻患者作为研究对象,根据随机数字表法将其分为对照组和观察组,各40例。对照组接受腓骨近端截骨治疗,观察组接受改良Ilizarov微创胫骨近端截骨钢板内固定治疗。比较两组的手术效果。结果观察组的治疗总有效率为97.50%,显著高于对照组的85.00%(P<0.05)。术后3个月,观察组的股胫角、机械轴偏移距离均小于对照组(P<0.05)。术后48 h,观察组的皮质醇(Cor)、去甲肾上腺素(NE)、C反应蛋白(CRP)水平低于对照组(P<0.05)。术后3个月,观察组的Lysholm膝关节功能评分高于对照组,西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分低于对照组(P<0.05)。结论改良Ilizarov微创胫骨近端截骨钢板内固定可缓解机体应激反应,提高内翻矫正效果及整体疗效,有助于患者术后膝关节功能恢复,值得推广。Objective To explore the application effect of modified Ilizarov minimally invasive proximal tibial osteotomy plate internal fixation in knee osteoarthritis with knee varus and its influence on varus correction.Methods A total of 80 patients with knee osteoarthritis complicated with knee varus who were admitted in our hospital from February 2021 to March 2023 were selected as the research objects.According to the random number table method,the patients were divided into control group and observation group,with 40 cases in each group.The control group was treated with proximal fibular osteotomy,and the observation group was treated with modified Ilizarov minimally invasive proximal tibial osteotomy plate internal fixation.The surgical effects of the two groups were compared.Results The total effective rate of treatment in the observation group was 97.50%,which was significantly higher than 85.00%in the control group(P<0.05).At 3 months after operation,the femoral tibial angle and mechanical axis offset distance of the observation group were smaller than those of the control group(P<0.05).At 48 h after operation,the levels of cortisol(Cor),norepinephrine(NE)and C-reactive protein(CRP)in the observation group were lower than those in the control group(P<0.05).At 3 months after operation,the Lysholm knee function score of the observation group was higher than that of the control group,and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score was lower than that of the control group(P<0.05).Conclusion The modified Ilizarov minimally invasive proximal tibial osteotomy plate internal fixation can alleviate the body's stress response,improve the varus correction effect and overall efficacy,and contribute to the recovery of knee joint function after surgery,which is worthy of promotion.

关 键 词：膝关节骨性关节炎 膝内翻 腓骨近端截骨 改良Ilizarov微创胫骨近端截骨钢板内固定 

分 类 号：R614[医药卫生—麻醉学]