摘要
目的 探讨股骨远端内翻截骨加交锁髓内钉固定 ,治疗伴有膝外翻畸形的膝关节骨性关节炎的疗效。方法 1996年 5月～ 2 0 0 0年 8月 ,采用股骨远端内翻截骨加交锁髓内钉固定治疗 16例 (16膝 )伴膝外翻畸形的膝关节骨性关节炎 ,病程 1～ 2 1年 ,平均 5 .2年。按 Ahlback分类 度 10例 , 度 6例。股骨髁上截骨 11例 ,股骨干远端截骨 5例。术前、术后 8周和 2年均行患肢全长 X线片检查 ,以测量股胫角、胫骨角、股骨角及胫股关节面切线夹角及胫股外侧间距大小。按膝关节功能评定标准 ,评定术后膝关节功能恢复情况。 结果 16例术后获随访 2 5～ 4 6个月 ,平均 31个月。术后 2年随访骨愈合满意 ,1例延迟愈合 ,为股骨干远端截骨患者。皮肤感染 1例。膝关节功能自 5 0 .4± 15 .9分增至 78.5± 12 .9分 ,胫股关节面切线夹角自 5 .6± 2 .9°减少至 1.6± 3.4°,胫股外侧关节间距自 2 .1± 1.8mm增至 4 .7±1.7m m。 结论 股骨远端内翻截骨加交锁髓内钉内固定 ,可作为治疗伴有膝外翻畸形的膝关节骨性关节炎的有效方法之一。
Objective To assess the effect of medial dista femoral osteotomy combined with interlocking nailing on the treatment of knee osteoarthritis with valgus deformity. Methods From May 1996 to August 2000, 16 patients with knee osteoarthritis accompanied by valgus deformity were treated by medial wedged distal femoral osteotomy combined with interlocking nailing. Full length radiographs were taken before operation and 8 weeks and 2 years after operation. The parameters, including the femorotibial angle, the tibial angle, the femoral angle, the femoral condyle tibial plateau angle, and the lateral joint space, were measured by these radiographs. The function of knee was evaluated by the 100 point rating scale standard of knee. Results The mean postoperative score was significantly improved from 50.4±15.9 points to 78.5±12.9 points 2 years after the surgery. The lateral joint space was increased from 2.1±1.8 mm to 4.7±1.7 mm and the femoral condyle tibial angle decreased from 5.6±2.9° to 1 6±3 4°. There were complications in 2 cases: 1 case of delayed union and 1 case of superficial wound infection. Conclusion Medial distal femoral osteotomy combined with interlocking nailing proves to be an effective approach to treat knee osteoarthritis with valgus deformity.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2005年第3期192-194,共3页
Chinese Journal of Reparative and Reconstructive Surgery
