股骨遠端內側閉合截骨術中并發外側合頁骨折兩例_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

張志廣 , 邱越 , 環大維 , 張超 , 夏天衛 ,  沈計榮

南京中醫藥大學附屬醫院骨傷科（南京 210029）;

Corresponding?author：

沈計榮, Email: joint66118@sina.com

Keywords：

股骨遠端內側閉合截骨術; 外側合頁骨折; 并發癥

DOI：

10.7507/1002-1892.202212046

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目的總結2例股骨遠端內側閉合截骨術中并發外側合頁骨折的診治經驗。方法 2022年6月及9月共收治2例膝關節外側單間室關節炎伴外翻畸形女性患者。患者年齡為54、47歲，患膝關節活動度分別為0°～110°、0°～120°，美國特種外科醫院（HSS）評分分別為78、72分，疼痛視覺模擬評分（VAS）均為2分。股骨遠端內側閉合截骨術中發生外側合頁骨折，予以鎖定加壓遠端股骨接骨板固定。結果術后切口Ⅰ期愈合。2例患者分別獲隨訪2、3個月，患者膝關節疼痛明顯減輕，VAS評分均為0分；外翻畸形矯正，膝關節活動度分別為0°～120°、0°～130°，HSS評分分別為82、85分；影像學檢查示截骨端愈合良好，未出現關節炎進展，力線位置滿意。結論股骨遠端內側閉合截骨術中并發外側合頁骨折均為不穩定性骨折，可選擇外側接骨板固定以降低對矯正手術效果的影響。

Citation： 張志廣, 邱越, 環大維, 張超, 夏天衛, 沈計榮. 股骨遠端內側閉合截骨術中并發外側合頁骨折兩例. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(4): 507-508. doi: 10.7507/1002-1892.202212046 Copy

1.	Kim TW, Lee MC, Cho JH, et al. The ideal location of the lateral hinge in medial closing wedge osteotomy of the distal femur: analysis of soft tissue coverage and bone density. Am J Sports Med, 2019, 47(12): 2945-2951.
2.	Nha KW, Chang YS, Shon OJ, et al. Where is the target point to prevent cortical hinge fracture in medial closing-wedge distal femoral varus osteotomy? J Knee Surg, 2019, 32(3): 274-279.
3.	Kim SC, Kim JS, Yoo HJ, et al. Factors affecting the disparity between preoperative planning and postoperative correction status in distal femoral osteotomy. Knee, 2020, 27(5): 1608-1617.
4.	Nakayama H, Kanto R, Iseki T, et al. How the orientation of osteotomy in biplanar lateral closed-wedge distal femoral osteotomy influences the rotational alignment of the knee in all dimensional planes. Knee, 2021, 29: 167-173.
5.	Matsushita T, Akiyama T, Osano K, et al. Biomechanical analysis of the role of hinge support fixators on hinge stability in medial closing wedge distal femoral osteotomy. Clin Biomech (Bristol, Avon), 2022, 91: 105528. doi: 10.1016/j.clinbiomech.2021.105528.

1. Kim TW, Lee MC, Cho JH, et al. The ideal location of the lateral hinge in medial closing wedge osteotomy of the distal femur: analysis of soft tissue coverage and bone density. Am J Sports Med, 2019, 47(12): 2945-2951.
2. Nha KW, Chang YS, Shon OJ, et al. Where is the target point to prevent cortical hinge fracture in medial closing-wedge distal femoral varus osteotomy? J Knee Surg, 2019, 32(3): 274-279.
3. Kim SC, Kim JS, Yoo HJ, et al. Factors affecting the disparity between preoperative planning and postoperative correction status in distal femoral osteotomy. Knee, 2020, 27(5): 1608-1617.
4. Nakayama H, Kanto R, Iseki T, et al. How the orientation of osteotomy in biplanar lateral closed-wedge distal femoral osteotomy influences the rotational alignment of the knee in all dimensional planes. Knee, 2021, 29: 167-173.
5. Matsushita T, Akiyama T, Osano K, et al. Biomechanical analysis of the role of hinge support fixators on hinge stability in medial closing wedge distal femoral osteotomy. Clin Biomech (Bristol, Avon), 2022, 91: 105528. doi: 10.1016/j.clinbiomech.2021.105528.

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