胫骨高位截骨治疗膝关节骨陛关节炎.pdfVIP

中国骨伤2008年3月第21卷第3期 China J Orthop＆Trauma，Mar．2008，Vo1．21，No．3 · 211· · 经 验 交 流 · 胫骨高位截骨治疗膝关节骨陛关节炎 张功林，章鸣，蔡国荣，郭翱，张文正，胡玉祥，丁法明 (温岭市骨伤科医院，浙江 温岭 317500) 【摘要】 目的：总结外侧闭合楔形胫骨高位截骨术(hightibial osteotomy，HTO)治疗膝关节单间室骨性关节炎引 起的关节疼痛临床应用结果。方法：应用外侧闭合楔形HTO治疗9例(男3例，女6例)伴内翻畸形的膝关节单间室骨 性关节炎。年龄52-58岁，平均56岁。术中显露胫腓关节近侧，切开前侧关节囊，用骨锯或骨刀去除外侧楔形骨块，闭 合截骨处缺损后用“U”形钉固定。结果：手术顺利，无手术并发症，经2～5、5年(平均3．5年)随访，按膝关节骨性关节炎 疗效评定标准：优5例，良好3例，尚可1例。结论：外侧闲合楔形HTO是治疗膝关节单间室骨性关节炎引起关节疼痛 的有效手术方法，但不适用于年龄过大的患者(60岁)。 【关键词】 截骨术； 胫骨； 膝关节； 骨关节炎 High tibial osteotomy for the treatment of osteoarthritis of the knee ZHANG Gong-lin，ZHANG Ming，CAI Guo-rong， GUO Ao，ZHANG Wen-zheng，HU Yu-xiang，DING Fa-ming．Orthopaedics and Traumatology Hospitol ofWenlingCity，Wen- ling 317500，Zhej／ang，China ABSTRACT Objective：To summarize clinical application of the high tibial osteatomy(HTO)with lateral closing-wedge f- or the treatment of pain of unicompartmental osteoarthritis of the knee、Methods：From February 2000 to February 2004，9 pa． tients(3 males and 6 females，ranging in age from 52 to 58 years，with an average of 56 years)with unicompartmental OS- teoarthritis of the knee treated by HTO with lateral closing-wedge、The proximal tibiofibular joint was exposed，the anterior part of the capsule was incised，and to remove a laterally based wedge with saw cuts and osteotomes、Stepped staples were used for the fixation of tibial osteotomies after closing the defect of osteotomy．Results：The operative course was uneventful、There were no complications after operation．The postoperative follow-up period ranged from 2 to 5．5 years(mean，3．5 years)．The msul- ts were evaluated with functional assessment criterion of the osteoarthritis of the knee，among the 9 cases，excellent was in 5 cases，good in 3 cases，fair in 1 case、Conclusion：HTO with lateral closing-wedg