GIEBEL系统在胫骨高位截骨术中应用.docVIP

GIEBEL系统在胫骨高位截骨术中应用 　 作者：张海宁，王英振，吕成昱，刘金钊，王湘达，王昌耀 【摘要】 ［目的］探讨GIEBEL内固定系统固定的胫骨高位截骨术治疗膝内翻畸形的效果。［方法］对19例31膝，平均53.5岁的膝内翻患者进行评价。术前内翻畸形平均12.29°；膝关节症状以内侧间室疼痛为主。不伴有其他关节间室病变。对患膝进行精确的胫骨高位截骨术后应用GIEBEL系统内固定截骨端。手术前后拍摄双下肢负重位全长X线片，测量内翻角、机械轴线和解剖轴线。记录内外侧关节间隙距离的差值以及关节活动度。同时进行Lysholm评分。术后对患者进行主观满意度调查。［结果］对19例患者平均随访22个月。术后1例腓总神经一过性麻痹，2例切口脂肪液化延迟愈合。截骨处至术后12～16周均骨性愈合。测量矫正角度平均12.32°。3例患者残留膝前疼痛和关节绞锁症状。在随访期间膝内外侧间隙无明显退变加重。手术效果优良率为89.5%。84.2%患者对手术效果表示满意。除膝关节活动度外，Lysholm评分、内外关节间隙差以及内翻角度在手术前后差异均有统计学显著性差异。［结论］GIEBEL系统可有效地固定胫骨高位截骨术截骨端，对轻中度膝关节内翻畸形患者固定强度大，骨愈合率高。 【关键词】 胫骨； 截骨术； 畸形； 内固定 　　Clinical application of the GIEBEL system in high tibial osteotomy∥ 　　Abstract：［Objective］To discuss the results of the GIEBEL system in high tibial osteotomy to treat varus knee.［Method］Nineteen patients with medium varus knee were selected to be treated with osteotomy.Preoperatively,the mean varus angle was 12.29°,without deformity in other department of the knee joint.The main symptom was the pain in medial department.Accurate high tibial osteotomy with GIEBEL system fixation was performed in 31 knees of these patients.Weightbearing extremity Xray testing,varus angle,mechanical axle and anatomical axle were marked preoperatively and postoperatively.Joint space discrepancy between lateral and medial joint,the range of motion,Lysholm assessment and objective satisfactory survey were also performed to determine the outcome of the treatment.［Result］The mean followup of nineteen patients was 22 months.During this period,one case of temporary common fibular nerve paralysis occurred and healed at several days.All of the osteomy interface achieved bony healing.The corrected abnormality was 12.32°.The mechanism axle of the extremity maintained as the level just after operation during the followup and no degeneration of the joint space aggravated.The excellent and good rate of the treatment was 89.5%,and 84.2% of the patients expressed satisfactory for the operation.No difference of the range of motion was found befor