本文選題：脛骨近端截骨　切入點(diǎn)：膝關(guān)節(jié)　出處：《中國矯形外科雜志》2017年11期

【摘要】：[目的]脛骨近端截骨術(shù)聯(lián)合采用股二頭肌長頭腱重建膝關(guān)節(jié)后外側(cè)結(jié)構(gòu)并探討其在兒麻后遺癥嚴(yán)重膝內(nèi)翻畸形矯正中的臨床效果。[方法]2011年8月~2015年8月對7例兒麻后遺癥嚴(yán)重膝內(nèi)翻畸形患者,一期均行脛骨近端截骨術(shù),二期取內(nèi)固定時,同時采用股二頭肌長頭腱重建膝關(guān)節(jié)后外側(cè)結(jié)構(gòu)。[結(jié)果]一期脛骨近端截骨術(shù)后均隨訪20~48個月,平均25.40個月。在非負(fù)重狀態(tài)下,所有脛骨內(nèi)翻畸形均矯正;在負(fù)重狀態(tài)下,術(shù)前膝內(nèi)翻角度30°~45°,平均37.10°,術(shù)后膝內(nèi)翻角度8°~14°,平均11.70°,矯正角度20°~31°,平均25.4°,所有膝內(nèi)翻畸形較術(shù)前有改善。截骨端愈合時間3~5個月,平均3.50個月。二期膝關(guān)節(jié)后外側(cè)重建術(shù)后隨訪12~24個月,術(shù)后12個月,完全伸膝位無內(nèi)翻不穩(wěn);屈膝30°,Ⅰ度內(nèi)翻不穩(wěn)1例;屈膝30°,患側(cè)小腿外旋較健側(cè)增加1例。術(shù)后24個月,患膝后外側(cè)結(jié)構(gòu)的穩(wěn)定性無明顯改變,下肢力線恢復(fù)滿意。[結(jié)論]脛骨近端截骨術(shù)可以糾正脛骨內(nèi)翻畸形,改善膝內(nèi)翻畸形;采用股二頭肌長頭腱重建膝外側(cè)副韌帶和乆肌腱,能夠有效恢復(fù)膝關(guān)節(jié)后外側(cè)結(jié)構(gòu)的穩(wěn)定性;兩者聯(lián)合應(yīng)用在兒麻后遺癥嚴(yán)重膝內(nèi)翻畸形矯正中可以取得較好療效。
[Abstract]:[objective] to study the clinical effect of proximal tibial osteotomy combined with long head tendon of biceps femoris for reconstruction of posterolateral structure of knee joint and its application in correction of severe varus genu varus deformity. [methods] from August 2011 to August 2015. A case of severe varus genu deformity after anaesthesia, One stage proximal tibia osteotomy was performed, and the posterior lateral structure of knee joint was reconstructed with the tendon of the long head of biceps femoris muscle. [results] the follow-up of primary proximal tibial osteotomy was 20 ~ 48 months (mean 25.40 months). All tibial varus deformities were corrected under weight-bearing condition, the preoperative knee varus angle was 30 擄/ 45 擄(mean 37.10 擄), the postoperative knee varus angle was 8 擄/ 14 擄(mean 11.70 擄), the corrected angle was 20 擄/ 31 擄(mean 25.4 擄). The average of 3.50 months was 3.50 months. Follow-up for 12 ~ 24 months after secondary posterolateral reconstruction of the knee, 12 months after operation, no varus instability in complete extensor position, 30 擄flexion, 1 case with degree 鈪，

本文編號：1669411