胫骨高位截骨Link槽式钢板内固定治疗膝关节骨性关节炎并膝内翻

Osteoarthritis of Knee Treated by High Tibia Osteotomy Operation with LINK Giebel Blade Plates

目的 :总结应用Link槽式钢板的胫骨高位截骨术 (HTO)治疗膝关节骨性关节炎并膝内翻的疗效。方法 :1999年 3月～ 2 0 0 2年 12月共 18例膝关节骨性关节炎并膝内翻患者接受HTO并应用Link槽式钢板内固定 ,其中男性 3例 ,女性 15例 ,年龄最大 62岁 ,最小 43岁 ,平均 5 1岁 ,膝内翻角度最大 2 4° ,最小 8° ,平均 17° ,HSS膝关节评分平均 71分。结果 :全部病例术后随访最长 3年 ,最短 6个月 ,平均 2 5个月 ,均获得骨性愈合 ,截骨处无移位及松动 ,内固定无断裂 ,膝关节屈伸活动度同术前 ,纠正膝内翻角度平均 2 2° ,股胫角 (FTA)平均达到外翻 9° ,HSS膝关节评分平均为 86分 ,较术前增加 15分。 1例患者术后出现腓总神经牵拉症状 ,2个月后消失。 1例患者术后因脂肪液化伤口延迟愈合 ,换药后痊愈。结论 :HTO可明显改善骨性关节炎并膝内翻患者的下肢负重轴线及局部血供 ,降低骨内压 ,疗效满意。Link槽式钢板设计简单 ,固定可靠 ,截骨角度可准确掌握 ,是HTO理想的内固定选择。

Objective:To summarize the effects of high tibial osteotomy(HTO) with LINK giebel blade plates internal fixation in the treatment of knee OA with genu varum.Methods:Eighteen cases of knee OA with genu varum were performed HTO by using Link giebel blade plates.Among them,3 were male and 15 were females.The age of patients ranged from 43 to 62 years(averaged 51 years),and the range of genu varum angle were from 8° to 22° (averaged 17°).The mean score according to HSS knee joint standard was 71.Results:All cases which were followed-up from 6 months to 3 years(averaged 25 months) postoperatively had got good fusion,and the movement of the knee had the same range as preoperation.The mean corrected angle of genu varum was 22°,FTA achieved to 9° of eversion.The mean score according to HSS standard was 86,which had achieved 15 than preoperation.Conclusion:HTO can apparently correct the weight loading axis of knee OA with genu varum and improved the blood supply in locus,decrease the pressure in the tibial.The Link giebel blade plates which had simple design and reliable fixation can control the osteotomy angle accurately,and are ideal choice of internal fixation for HTO.