Ilizarov技术联合胫腓骨上段微创截骨治疗膝内翻骨关节炎

发布时间：2018-07-26 16:21

【摘要】：[目的]观察Ilizarov技术联合胫腓骨上段微创截骨治疗膝内翻骨关节炎的临床疗效,探讨骨关节炎治疗的有效方法。[方法]2010年1月~2015年12月,回顾性分析本科诊治的36例患者,均为单纯走平路膝关节疼痛病例。男25例,女11例;平均年龄58.5岁。36例共39膝,其中左膝19例,右膝14例,双膝3例。骨关节炎分级:2级15膝,3级24膝。术前VAS评分平均7.0分。术前胫骨近端内侧角平均62.5°,胫股角平均167.30。按HSS膝关节功能标准评估,平均58.4分。39膝均行胫腓骨上段微创截骨,Ilizarov外固定器固定术逐渐矫形。[结果]36例39膝患者手术时间40~95 min,平均55.0 min。单纯胫腓骨截骨矫形外固定时间30~60 min,平均45.5min。未出现神经血管损伤等并发症。35例38膝患者获得门诊复查、电话等的随访,平均34.5个月,末次随访时VAS评分平均2分,患膝负重正侧位X线片示胫骨近端内侧角平均96°,胫股角平均7.5°。HSS膝关节功能标准评分平均88.7分。秦泗河肢体残疾矫正的评价标准,优30膝,良6膝,可2膝,优良率94.7%。[结论]Ilizarov技术联合胫腓骨近端微创截骨治疗膝内翻骨关节炎效果确实,微创可调,操作简便,可以用于冠状面和矢状面的矫形,适合不同程度膝内翻骨关节炎患者的选择。
[Abstract]:[objective] to observe the clinical effect of Ilizarov combined with minimally invasive osteotomy of upper tibia and fibula in the treatment of knee varus osteoarthritis. [methods] from January 2010 to December 2015, 36 cases of knee joint pain were analyzed retrospectively. There were 25 males and 11 females, with an average age of 58.5 years. 36 patients had 39 knees, including 19 left knees, 14 right knees and 3 double knees. Osteoarthritis grade: grade 2, grade 15, knee grade, grade 3, 24 knees. The mean VAS score was 7. 0 before operation. The medial angle of proximal tibia and the average tibiofemoral angle were 62.5 掳and 167.30 掳respectively. According to the HSS knee function standard, the average score of 58.4. 39 knees underwent minimally invasive osteotomy of the upper tibia and fibula with Ilizarov external fixator fixation. [results] the operative time was 4095 min (mean 55.0 min) in 36 cases (39 knees). The external fixation time of tibia and fibula osteotomy was 30 minutes and 60 minutes, with an average of 45. 5 minutes. There were no complications such as nerve and blood vessel injury. 35 cases (38 knees) were followed up by outpatient examination, telephone and so on for an average of 34.5 months. At the last follow-up, the average VAS score was 2 points. The average medial angle of proximal tibia was 96 掳and the average angle of tibiofemoral angle was 7.5 掳. The average score of knee joint function score of HSS was 88.7. The evaluation criteria of Qin Sihe limb disability correction were excellent 30 knees, good 6 knees, fair 2 knees, excellent and good rate 94.7. [conclusion] Ilizarov combined with minimally invasive osteotomy of proximal tibia and fibula is effective, minimally invasive and easy to operate in the treatment of knee varus osteoarthritis. It can be used in the correction of coronal and sagittal plane and is suitable for the choice of patients with different degrees of varus osteoarthritis.
【作者单位】：国家康复辅具研究中心附属康复医院矫形外科;
【基金】：民政部老龄服务共性技术研究及应用示范项目课题(编号:2015BAI06B00)
【分类号】：R687.31

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