闭合楔形胫骨高位截骨的并发症

Complications of closing wedge high tibial osteotomy for medial compartment arthritis

胫骨高位截骨是治疗单间室膝关节炎的一项疗效确切的手术方式，可以有效缓解临床症状，并获得良好的中远期疗效。闭合楔形胫骨高位截骨是其中最常用、最成熟的一种术式。然而，它同时也对手术技术要求较高，存在10％-20％的并发症率。这些并发症包括神经血管损伤、筋膜室综合征、继发骨折、感染、血栓性疾病、截骨延期愈合或不愈合、矫正不足和畸形复发、胫骨后倾变化，甚至需要转换成人工全膝关节置换。这些并发症的出现，与术前设计、手术操作等密切相关。理解这些的并发症对获得更好的临床结果很重要。本文通过对相关研究及文献进行总结，探讨闭合楔形胫骨高位截骨的并发症发生情况、发生原因、预防和治疗方法。

Closing wedge high tibial osteotomy is a common, effective and we11-estahlished procedure to treat unicompartment osteoarthrosis of the knee. Given the nature of the procedure, significant potential complications exist, including neurovascular complications, compartment syndrome, fractures, infection, thromboembolic disease, delayed union and nonunion, under correction and recurrence of deformity, changing of the slope, and even finally resulting in total knee arthroplasty. A number of techniques have been described, with the ultimate goal of obtaining appropriate alignment to provide pain relief and functional improvement over a long-term period. Careful surgical technique is necessary to achieve these goals with a minimal risk of complication. This article discussed some of these complications and presented an overview of the current literature. It examined current thoughts on aetiology, techniques to try to avoid, and methods of treatment of these complications.