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Retrograde dynamic locked nailing for valgus knee correction: A revised technique

机译:逆行动态锁定钉治疗外翻膝关节矫正术

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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. 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. 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 3.4 months (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). 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.
机译:目的:传统上,外翻膝关节畸形主要通过用内侧入路插入股骨con上区域的钢板稳定来矫正。但是,从生物力学和生物学的观点来看,该技术都是不利的。开发了一种改良的逆行动态锁定钉,以改善对此缺陷的矫正。方法:对25例成年患者的外翻畸形(平均胫股角为22°;范围为16-29°)的41膝进行股骨sup上内翻内翻截骨术,并用逆行动力锁定钉固定。术后应鼓励早期步行,并应保护负重并进行膝关节运动。结果:对21例患者的35膝进行了平均2.6年(1.1-4.5年)的随访。所有截骨部位均愈合,平均愈合时间为3.4个月(范围为2.5-5.0个月)。没有明显的并发症。在最新的随访中,平均胫股角为7.1°外翻角(范围为4-10°外翻角)。对于所有膝盖,结果均令人满意(p <0.001)。结论:此处介绍的技术可能是矫正外翻膝关节畸形的可行替代方法。该技术的优点包括使用生物力学上更合适的方法,最小的并发症发生率和较高的满意结果率。

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