重度膝外翻的外科治疗

Surgical Treatment of Myositis Ossificans Adjacent to the Joint

目的 :报道 18例重度膝外翻的外科治疗 ,作者对重度膝外翻的畸形成因、截骨平面选择和固定方法进行探讨。方法 :18例病人男 7例 ,女 11例 ,年龄 12～ 3 4岁 ,双侧者 16例 ,共 3 4个膝。术前膝外翻畸形平均 42° ,立位双踝之间的距离最多者 5 5cm。手术方法 :单纯实施股骨髁上截骨者 16膝 ,股骨髁上 +胫骨结节下双截骨 18膝。结果 :2 7膝平均随访 16个月 ,畸形完全矫正无并发症者 2 3膝 ,大部矫正者 3膝 ,并发 8°膝内翻者 1膝。结论 :术前精密的手术设计、正确的手术操作、用骨外固定器固定截骨段 ,对不同类型的重度膝外翻可达良好治疗效果。

Objective: To analyze the clinical characteristics and surgical treatment of myositis ossificans adjacent to joint.Methods:The predisposing factors,effects on the function of joint and the pressure symptom of nerve and vascular of myositis ossificans adjacent to joint in 28 cases in the past 10 years were analyzed and the corresponding methods of prevention were introduced.Results:All 28 cases of myositis ossificans had injury history, among which 22 cases of fracture were reducted repeatedly,16 cases had secondary pressure symptom of nerve and vessels. The function of all the involved joints were seriously damaged.Conclusions:The damages of myositis ossificans adjacent to joint to the function of joint and the secondary pressure of nerve and vessels were more serious than that not adjacent to the joint.This study would have some reference value for the prevention and cure of myositis ossificans.