腓骨截骨治疗膝骨性关节炎的近期临床效果研究

发布时间：2018-04-23 15:29

本文选题：腓骨截骨 + 膝骨性关节炎　；参考：《山西医科大学》2016年硕士论文

【摘要】：目的:探讨腓骨截骨手术对膝骨性关节炎患者的近期临床治疗效果。方法:自2015年1月起,我科收治以内侧间隙疼痛为主要表现的膝骨性关节炎患者12例(15膝);全部为女性患者,年龄48~72岁,平均年龄61.3岁;膝骨关节炎发病时间0.5~10年,平均5.3年。均采用腓骨截骨手术,即于患肢同侧腓骨小头下6-10cm处截取2-3cm腓骨对其膝关节骨性关节炎进行治疗。术后1天下地适当进行关节活动,对患者手术前后进行相应影像学评估,并观察记录以下指标:术前、术后2天、术后2月VAS、HSS、KSS评分,分析各项指标变化情况。结果:1.所有患者住院天数平均6天;单侧手术时间为25~55分钟,平均单侧手术时间33.3分钟,术中均无明显出血。术后均未出现伤口感染、延迟愈合及神经损伤等并发症。2.所有患者均于术后1天下地行走,主诉原有膝关节内侧间隙疼痛明显好转或消失。术后2天复查膝关节负重位X线片,与术前膝关节负重位X线片比较,出现不同程度膝关节内侧间隙增高。3.患者手术后2天与术前相比,术后患者的VAS评分、HSS评分及KSS临床评分三项较术前明显好转(P0.05),患者手术后2月与术前相比,术后患者的VAS评分、HSS评分、KSS临床评分及KSS功能评分四项较术前均明显好转(P0.05)。结论:腓骨截骨术手术操作简单,创伤小,术后疼痛减轻明显,关节功能恢复良好,是治疗内翻型膝骨性关节炎的有效方法。
[Abstract]:Objective: to investigate the short-term clinical effect of fibula osteotomy on knee osteoarthritis. Methods: from January 2015, 12 cases of knee osteoarthritis with medial space pain as the main manifestation were treated in our department, all of them were female patients, aged 48 ~ 72 years, with an average age of 61.3 years, and the onset time of knee osteoarthritis was 0.5 ~ 10 years (mean 5.3 years). All patients were treated with fibula osteotomy, in which 2-3cm fibula was amputated at the 6-10cm of the ipsilateral fibula under the head of fibula to treat osteoarthritis of the knee. One day after operation, appropriate joint movement was carried out, and the corresponding imaging evaluation was performed before and after operation. The following indexes were observed and recorded: before, 2 days after operation, 2 days after operation, VAS-HSS-KSS score, and the changes of each index were analyzed. The result is 1: 1. The average hospitalization time of all patients was 6 days, the time of unilateral operation was 2555 minutes and the average time of unilateral operation was 33.3 minutes. No postoperative complications such as wound infection, delayed healing and nerve injury were found. All the patients walked on the ground 1 day after operation and complained that the pain in the medial space of the original knee was obviously improved or disappeared. The results showed that the medial space of knee joint increased at different degrees compared with the preoperative radiographs of knee joint loading position 2 days after operation. Two days after operation, VAS scores and KSS clinical scores were significantly improved in patients 2 days after operation compared with those before operation (P 0.05), and compared with those before operation at 2 months after operation. The VAS scores, clinical scores and KSS functional scores were significantly improved after operation than those before operation (P 0.05). Conclusion: fibula osteotomy is an effective method for the treatment of varus knee osteoarthritis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4

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