膝内侧骨关节炎患者的胫骨近端双平面截骨锁定钢板固定治疗

发布时间：2018-03-02 02:26

本文关键词： 骨关节炎膝膝关节矫形外科手术截骨术　出处：《中国骨与关节杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的探讨胫骨近端双平面截骨Tomo Fix锁钉钢板固定技术治疗内侧间室膝骨关节炎疗效。方法 2012年10月至2015年6月,为40例符合纳入标准的内侧间室膝关节骨关节炎的患者,通过胫骨近端双平面截骨Tomo Fix锁钉钢板固定技术进行治疗。对术前术后的股骨胫骨角(FTA)、疼痛评分(VAS评分)和髌骨高度(Insall-Salvati Index,IS指数)的改变进行评价,记录骨愈合情况和并发症的发生及处理。结果手术均成功,FTA矫正(9~20)°,平均(17.0±2.3)°。VAS评分,术前4~10分,平均(7.5±1.8)分,术后1~4分,平均(1.8±0.8)分。HSS功能评分,术前55~62分,平均(58.6±1.8)分,术后77~86分,平均(81.6±3.4)分明显改善。髌骨高度变化差异无统计学意义。所有截骨均愈合,无深部感染及钢板外露、无神经损伤发生,1例出现手术切口浅表感染,经换药后逐渐愈合。结论严格掌握手术适应证是保证疗效的前提,精确的手术技术是保证疗效的关键。术前计划和术中的力线调整对于保证手术成功至关重要。胫骨近端双平面截骨Tomofix锁钉钢板固定术治疗内侧间室膝骨关节炎安全有效。
[Abstract]:Objective to investigate the proximal tibial osteotomy and Tomo double plane Fix locking plate fixation for the treatment of medial compartment knee osteoarthritis. Methods from October 2012 to June 2015, 40 patients with medial compartment inclusion criteria of knee osteoarthritis patients with proximal tibial osteotomy and Tomo double plane Fix locking plate fixation technique for treatment. The preoperative and postoperative femoral tibial angle (FTA), pain score (VAS score) and patellar height (Insall-Salvati Index, IS index) to evaluate the change of the incidence and treatment records of bone healing and complications. Results the operation was successful, the FTA correction (9~20) average (17 degrees. + 2.3).VAS score, preoperative 4~10 score, the average (7.5 + 1.8), 1~4 after the operation, the average (1.8 + 0.8).HSS score, preoperative 55~62 score, the average (58.6 + 1.8), 77~86 after the operation, the average (81.6 + 3.4) was significantly improved. No statistical changes of patellar height difference Learn the meaning of all. Osteotomy healed, no deep infection and plate exposure, no nerve injury occurred, 1 cases of incision superficial infection after the dressing up gradually. Conclusion the indications for surgery is the prerequisite of ensuring the curative effect, surgical technique is the key to ensure accurate preoperative planning and curative effect. In the operation of force line adjustment to ensure the operation success. The proximal tibial osteotomy and Tomofix plane double locking plate fixation for the treatment of medial compartment knee osteoarthritis is safe and effective.

【作者单位】：北京昌平区医院骨科;北京积水潭医院矫形骨科;
【分类号】：R687.4

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