giebel系統(tǒng)在脛骨高位截骨術(shù)中的應(yīng)用

《giebel系統(tǒng)在脛骨高位截骨術(shù)中的應(yīng)用》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫(kù)。

1、GIEBEL系統(tǒng)在脛骨高位截骨術(shù)中的應(yīng)用作者：張海寧，王英振，呂成昱，劉金釗，王湘達(dá)，王昌耀【摘要】［目的］探討GIEBEL內(nèi)固定系統(tǒng)固定的脛骨高位截骨術(shù)治療膝內(nèi)翻畸形的效果。［方法］對(duì)19例31膝，平均53.5歲的膝內(nèi)翻患者進(jìn)行評(píng)價(jià)。術(shù)前內(nèi)翻畸形平均12.29°；膝關(guān)節(jié)癥狀以內(nèi)側(cè)間室疼痛為主。不伴有其他關(guān)節(jié)間室病變。對(duì)患膝進(jìn)行精確的脛骨高位截骨術(shù)后應(yīng)用GIEBEL系統(tǒng)內(nèi)固定截骨端。手術(shù)前后拍攝雙下肢負(fù)重位全長(zhǎng)X線片，測(cè)量?jī)?nèi)翻角、機(jī)械軸線和解剖軸線。記錄內(nèi)外側(cè)關(guān)節(jié)間隙距離的差值以及關(guān)節(jié)活動(dòng)度。同時(shí)進(jìn)行Lysh

2、olm評(píng)分。術(shù)后對(duì)患者進(jìn)行主觀滿意度調(diào)查。［結(jié)果］對(duì)19例患者平均隨訪22個(gè)月。術(shù)后1例腓總神經(jīng)一過(guò)性麻痹，2例切口脂肪液化延遲愈合。截骨處至術(shù)后12～16周均骨性愈合。測(cè)量矯正角度平均12.32°。3例患者殘留膝前疼痛和關(guān)節(jié)絞鎖癥狀。在隨訪期間膝內(nèi)外側(cè)間隙無(wú)明顯退變加重。手術(shù)效果優(yōu)良率為89.5%。84.2%患者對(duì)手術(shù)效果表示滿意。除膝關(guān)節(jié)活動(dòng)度外，Lysholm評(píng)分、內(nèi)外關(guān)節(jié)間隙差以及內(nèi)翻角度在手術(shù)前后差異均有統(tǒng)計(jì)學(xué)顯著性差異。［結(jié)論］GIEBEL系統(tǒng)可有效地固定脛骨高位截骨術(shù)截骨端，對(duì)輕中度膝關(guān)節(jié)內(nèi)翻畸

3、形患者固定強(qiáng)度大，骨愈合率高?！娟P(guān)鍵詞】脛骨；截骨術(shù)；畸形；內(nèi)固定12　　ClinicalapplicationoftheGIEBELsysteminhightibialosteotomy∥　　Abstract：［Objective］TodiscusstheresultsoftheGIEBELsysteminhightibialosteotomytotreatvarusknee.［Method］Nineteenpatientswithmediumvaruskneewereselectedtobetreated

4、withosteotomy.Preoperatively,themeanvarusanglewas12.29°,withoutdeformityinotherdepartmentofthekneejoint.Themainsymptomwasthepaininmedialdepartment.AccuratehightibialosteotomywithGIEBELsystemfixationwasperformedin31kneesofthesepatients.Weightbearingextremit

5、yXraytesting,varusangle,mechanicalaxleandanatomicalaxleweremarkedpreoperativelyandpostoperatively.Jointspacediscrepancybetweenlateralandmedialjoint,therangeofmotion,Lysholmassessmentandobjectivesatisfactorysurveywerealsoperformedtodeterminetheoutcomeofthet

6、reatment.［Result］Themeanfollowupofnineteenpatientswas22months.Duringthisperiod,onecaseoftemporarycommonfibularnerveparalysisoccurredandhealedatseveraldays.Alloftheosteomyinterfaceachievedbonyhealing.Thecorrectedabnormalitywas12.32°.Themechanismaxleoftheext

7、remitymaintainedastheleveljustafter12operationduringthefollowupandnodegenerationofthejointspaceaggravated.Theexcellentandgoodrateofthetreatmentwas89.5%,and84.2%ofthepatientsexpressedsatisfactoryfortheoperation.Nodifferenceoftherangeofmotionwasfoundbeforean

8、dafteroperation,buttheLysholmscore,jointspacediscrepancybetweenlateralandmedialjointandvarusanglewereimprovedaftertheosteotomy.［Conclusion］TheGIEBELsystemcanfixatethebonyinterfaceofthehightibialosteoto