中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2012年
3期
199-204
,共6页
秦泗河%郑学建%夏和桃%韩义连%任龙喜
秦泗河%鄭學建%夏和桃%韓義連%任龍喜
진사하%정학건%하화도%한의련%임룡희
伊利扎罗夫技术%外固定器%截骨术%膝关节%畸形
伊利扎囉伕技術%外固定器%截骨術%膝關節%畸形
이리찰라부기술%외고정기%절골술%슬관절%기형
Ilizarov technique%External fixators%Osteotomy%Knee joint%Abnormalities
目的 探讨远端半针Ilizarov外固定器结合微创截骨术矫治膝内翻畸形的临床疗效.方法 回顾性分析2002年2月至2010年5月收治的31例膝内翻畸形患者的病例,男8例,女23例；年龄18～69岁,平均35.6岁；单侧6例,双侧25例,共56膝.术前膝内翻角度为7.7°～38.2°,平均17.0°±8.8°.根据美国膝关节关节协会评分(knee society score,KSS)为34～100分,平均(86.2±18.5)分.确定成角旋转中心与截骨矫形的位置,在胫骨畸形交点处用微创截骨器截骨,腓骨在头下截骨.安装术前已组装好的Ilizarov外固定器,通过调整伸缩内、外侧支架螺杆的长度渐进矫正内翻畸形.采用X线检查及膝关节KSS临床评分,结合行走时自我感觉及有无并发症等4项内容综合评价临床疗效.结果 患者佩戴Ilizarov外固定器的时间为9～20周,平均12周；随访时间14～50.4个月,平均30.5个月.末次随访时膝内翻角度为-3°～2.4°,平均1.7°±0.9°；膝关节KSS评分为75～100分,平均(96.1±7.7)分,其中优49例,良6例,可1例,优良率为98.2％ (55/56).11例患者术后早期发生轻度针道感染,经常规换药后感染控制；3例术后发生针道松动,经更换针道后恢复固定强度.结论 远端半针Ilizarov外固定器结合微创截骨术矫治膝内翻畸形具有微创、安全、动态矫形及符合美学要求的特点,临床效果满意.
目的 探討遠耑半針Ilizarov外固定器結閤微創截骨術矯治膝內翻畸形的臨床療效.方法 迴顧性分析2002年2月至2010年5月收治的31例膝內翻畸形患者的病例,男8例,女23例；年齡18～69歲,平均35.6歲；單側6例,雙側25例,共56膝.術前膝內翻角度為7.7°～38.2°,平均17.0°±8.8°.根據美國膝關節關節協會評分(knee society score,KSS)為34～100分,平均(86.2±18.5)分.確定成角鏇轉中心與截骨矯形的位置,在脛骨畸形交點處用微創截骨器截骨,腓骨在頭下截骨.安裝術前已組裝好的Ilizarov外固定器,通過調整伸縮內、外側支架螺桿的長度漸進矯正內翻畸形.採用X線檢查及膝關節KSS臨床評分,結閤行走時自我感覺及有無併髮癥等4項內容綜閤評價臨床療效.結果 患者珮戴Ilizarov外固定器的時間為9～20週,平均12週；隨訪時間14～50.4箇月,平均30.5箇月.末次隨訪時膝內翻角度為-3°～2.4°,平均1.7°±0.9°；膝關節KSS評分為75～100分,平均(96.1±7.7)分,其中優49例,良6例,可1例,優良率為98.2％ (55/56).11例患者術後早期髮生輕度針道感染,經常規換藥後感染控製；3例術後髮生針道鬆動,經更換針道後恢複固定彊度.結論 遠耑半針Ilizarov外固定器結閤微創截骨術矯治膝內翻畸形具有微創、安全、動態矯形及符閤美學要求的特點,臨床效果滿意.
목적 탐토원단반침Ilizarov외고정기결합미창절골술교치슬내번기형적림상료효.방법 회고성분석2002년2월지2010년5월수치적31례슬내번기형환자적병례,남8례,녀23례；년령18～69세,평균35.6세；단측6례,쌍측25례,공56슬.술전슬내번각도위7.7°～38.2°,평균17.0°±8.8°.근거미국슬관절관절협회평분(knee society score,KSS)위34～100분,평균(86.2±18.5)분.학정성각선전중심여절골교형적위치,재경골기형교점처용미창절골기절골,비골재두하절골.안장술전이조장호적Ilizarov외고정기,통과조정신축내、외측지가라간적장도점진교정내번기형.채용X선검사급슬관절KSS림상평분,결합행주시자아감각급유무병발증등4항내용종합평개림상료효.결과 환자패대Ilizarov외고정기적시간위9～20주,평균12주；수방시간14～50.4개월,평균30.5개월.말차수방시슬내번각도위-3°～2.4°,평균1.7°±0.9°；슬관절KSS평분위75～100분,평균(96.1±7.7)분,기중우49례,량6례,가1례,우량솔위98.2％ (55/56).11례환자술후조기발생경도침도감염,경상규환약후감염공제；3례술후발생침도송동,경경환침도후회복고정강도.결론 원단반침Ilizarov외고정기결합미창절골술교치슬내번기형구유미창、안전、동태교형급부합미학요구적특점,림상효과만의.
Objective To evaluate the effect of modified Ilizarov device combined with minimally invasive osteotomy in the treatment of genu varum deformity.Methods From February 2002 to May 2010,a total of 31 patients with genu varum deformity who had underwent corrections by using modified Ilizarov device combined with minimally invasive osteotomy were retrospectively analyzed,including 8 males and 23 females with an average age of 35.6 years (range,18-69 years).Fifty-six knees were involved in the 31 patients.Preoperative angle of genu varum was 17.0° ±8.8°.According to the American knee society score (KSS),preoperative score was about 34-100 point with an average of 86.2±18.5.After determining the center of rotation angulation,osteotomy was performed in the site of tibial deformity and below the fibular head with minimally invasive device respectively.Prepared modified Ilizarov device was assembled and fixed with kirschner wire.Then genu varum deformity was progressively corrected by adjusting the length of bilateral bolts.X-ray film,KSS score,subjective sensation,and occurrence of complication were used to evaluate the therapeutic effects.Results Modified Ilizarov devices were used in 56 knees for 9-20 weeks,all patients were followed up for 14-50.4 months,with an average of 30.5 months.The angle of genu varum deformity was 1.7°±0.9°,the KSS was 96.1±7.7.According to KSS,the results were excellent in 49 knees,good in 6,fair in 1,with the excellent and good rate was 98.2％ (55/56).The complications included pin site infection in 11 patients and pin loosening in 3 ones; they were healed through routine dressing change and replacing pin site respectively.Conclusion Modified Iilizarov device combined with minimally invasive osteotomy for the treatment of genu varum deformity can achieve a satisfactory therapeutic effect.
