CAJ | 학술논문

目的评价双平面开放胫骨高位楔形截骨治疗成人膝关节内翻畸形的手术效果.方法回顾性分析2001年6月至2008年7月存在膝关节内侧单间室退行性改变伴内翻畸形且进行双平面开放胫骨高位楔形截骨术治疗的12例患者的一般资料.术前膝内翻畸形5.0°～19.0°,平均11.5°;膝关节屈伸活动度大于90°;不伴有其他关节间室病变;1例伴有外侧副韧带及前交叉韧带断裂,行韧带重建手术后二期进行开放截骨矫形术.术前膝关节症状以内侧间室疼痛为主.手术前后测量患者关节活动度的大小,并对患者进行Lysholm评分.术后对患者进行主观满意度调查.结果 12例患者术后平均随访时间32.5个月.截骨处至术后12～16周均获得骨性愈合.矫正角度5.5°～18.0°,平均9.5°.在随访期间内X线检查下肢力线维持在术后水平,内外侧间室及髌股间室均未发现明显退变进展.手术总体效果优良率为83.3%,Lysholm评分、内翻角度变化在手术前后均有统计学显著性差异.结论双平面开放胫骨高位楔形截骨术对中青年膝关节内翻畸形伴单间室退行性改变有良好的早、中期效果.
목적 평개쌍평면개방경골고위설형절골치료성인슬관절내번기형적수술효과.방법 회고성분석2001년6월지2008년7월존재슬관절내측단간실퇴행성개변반내번기형차진행쌍평면개방경골고위설형절골술치료적12례환자적일반자료.술전슬내번기형5.0°～19.0°,평균11.5°;슬관절굴신활동도대우90°;불반유기타관절간실병변;1례반유외측부인대급전교차인대단렬,행인대중건수술후이기진행개방절골교형술.술전슬관절증상이내측간실동통위주.수술전후측량환자관절활동도적대소,병대환자진행Lysholm평분.술후대환자진행주관만의도조사.결과 12례환자술후평균수방시간32.5개월.절골처지술후12～16주균획득골성유합.교정각도5.5°～18.0°,평균9.5°.재수방기간내X선검사하지력선유지재술후수평,내외측간실급빈고간실균미발현명현퇴변진전.수술총체효과우량솔위83.3%,Lysholm평분、내번각도변화재수술전후균유통계학현저성차이.결론 쌍평면개방경골고위설형절골술대중청년슬관절내번기형반단간실퇴행성개변유량호적조、중기효과.
Objective To introduce the biplanar opening high tibial osteotomy with rigid fixation for adult varus knee. Methods Twelve patients with varus knee and degeneration of medial compartment received the biplanar opening high tibial osteotomy between June 2001 and July 2008. The pre-operative deformity was about 11.5° without osteoarthritis changes in other compartments. The average range of motion was more than 90°. One of the patients had ruptures of LCL and ACL, who received osteotomy after reconstruction of the ligaments. The main symptom before the operation was pain in medial compartment. The range of motion, Lysholm score and subjective satisfactory examinations were assessed before and after the osteotomy. Results All of the osteotomy sites were healed at twelve to sixteen weeks after operation. No complications such as plate broken or injury of nerve or blood vessel had occurred. The mean correct angle was 9. 5°. No degenerative changes had developed in other compartments of the knee. The mechanical axis of the lower extremities was maintained during the follow-up. The overall satisfactory rate was 83.3%.Statistically significant changes exist in the Lysholm score and varus degree. Conclusion The open-wedge high tibial osteotomy is suitable for the symptomatic genu varum in younger patients with good short-term and mid-term results.