Purpose

Traditionally, valgus knee deformity is predominately corrected by stabilisation with a plate inserted via the medial approach to the supracondylar region of the femur. However, this technique is unfavourable from both a biomechanical and a biological point of view. A revised retrograde dynamic locked nailing was developed to improve correction of this defect.

目的

传统上，膝外翻畸形的主流矫正方法是通过股骨髁内侧嵌入金属板进行固定。然而，从生物力学和生物学的角度来看，该项技术均不被支持。逆行动态交锁钉这项翻修技术有望改善这一缺陷的矫正。

Method

Forty-one knees with valgus deformity (average tibiofemoral angle, 22°; range, 16–29°) in 25 adult patients were treated by oblique femoral supracondylar varus osteotomy and stabilised with retrograde dynamic locked nails. Postoperatively, early ambulation with protected weight bearing and range of motion knee exercises were encouraged.

方法

选取25例成人患者的41个外翻畸形（平均胫股角：22°；范围：16–29°）膝，通过股骨髁上斜内翻截骨术进行治疗并通过逆行动态交锁钉固定。术后，鼓励患者进行有保护性负重的早期下床活动和一定范围的膝关节活动。

Result

Thirty-five knees of 21 patients were followed-up for an average of 2.6 years (range, 1.1–4.5 years). All osteotomy sites healed with an average union period of 3.4months (range,2.5–5.0 months). There were no significant complications. At the latest follow-up, the average tibiofemoral angle was 7.1° valgus (range, 4–10° valgus). For all of the knees, the outcomes were satisfactory (p<0.001).

结果

在随访的21例患者35个膝关节中，平均随访2.6年(范围：1.1–4.5年)。所有患者的截骨部位均愈合，平均愈合时间为3.4个月（范围：2.5-5.0个月）。无显著并发症。在最近一次随访中，平均胫股角为7.1°外翻（范围：4-10°外翻）。对于所有患者，疗效均令人满意（p<0.001）。

Conclusion

The technique described here may be a feasible alternative for correction of valgus knee deformity. The advantages of this technique include the use of a biomechanically more appropriate method, a minimal complication rate and a high rate of satisfactory outcomes.

结论

这项技术可成为膝外翻畸形矫正的一个可行性疗法。该技术的优势包括：生物力学方法更适当、并发症发生率更小及患者满意度更高。

由Midcool医库软件 王露黔 编译

原文来自：International Orthopaedics