股骨远端内侧闭合楔形截骨矫正中青年膝外翻

Distal femoral closed wedge osteotomy for young adults valgus knee: through the medial approach

[目的]探讨股骨远端内侧闭合楔形截骨术结合Tomofix锁定钢板治疗中青年膝关节外翻畸形并分析临床疗效。[方法]回顾分析2009年5月~2013年6月,采用股骨远端内侧闭合楔形截骨、Tomofix锁定钢板固定治疗28例（34膝）膝关节外翻畸形患者,分别观察术前和术后KOOS（Knee injury and osteoarthritis outcome score）评分、主观满意指数（Satisfaction Index,SI）、股胫角度改变及膝关节活动度,综合评价该手术方法对膝关节外翻畸形的治疗效果。[结果]所有患者均获随访,随访时间（35.7±11.13）个月（24~72个月）。所有患者X线片显示截骨部位全部获得骨性愈合。与术前相比,KOSS各项评分均显著提高（P〈0.01）,膝关节外翻畸形得到有效矫正（矫正范围：15.1°±3.7°,P〈0.01）,主观满意指数达到（84%±9%）,膝关节活动良好。[结论]股骨远端内侧闭合楔形截骨术矫正膝关节外翻畸形可取得较理想的治疗效果,值得推广应用。

[Objective] To evaluate the treatment effectiveness for valgus knee by distal femoral medial closeing wedge combined with Tomofix locking palte,and to provide important clinical data and theoretical basis for the use of this surgical procedure. [Methods] Twenty- eight patients（ thirty- four knees） with valgus knee were treated with distal femoral medial closed wedge osteotomy from May 2009 to June 2013. The treatment effect was evaluated by using standards and indicators of the Knee injury and Osteoarthritis Outcome Score（ KOOS）,Satisfaction Index（ SI）,tibialfemoral angle,the movement range of knee before and after operation,respectively. [Results] All patients were followed up for an average of（ 35. 7 ± 11. 13）months（ range,24 ~ 72 months）. Complete bone healing was obtained in all patients. Postoperative KOOS scores improved compared with preoperative ones,showing significant difference（ P 0. 01）. Satisfaction Index reached（ 84 ± 9） %,and valgus had been corrected effectively（ range of correction,15. 1 ± 3. 7°,P 0. 01）. The motion of knee joint was satisfactory.[Conclusion] Distal femoral medial closed wedge osteotomy is an effective method in treatment of valgus knee,it is worth popularizing.