成年人小腿外旋畸形外科治疗.pdf

中国矫形外科杂志 　2001 年 2 月第 8 卷第 2 期 　Orthop J Chin , Vol. 8 ,No. 2 February 2001 1·23 · ·论　著· 成年人小腿外旋畸形的外科治疗 秦泗河 　孙 　磊 　李丰才 　郑学建 　　摘 　要 　目的:探讨成年人小腿外旋畸形的成因、手术方法和治疗效果。方法 : 回顾性分析 138 例 144 条腿 ,平均年 龄 29. 3 岁。小儿麻痹后遗症 116 例 ,其它原因 22 例 ,其中 130 例合并髋、膝关节和踝足关节的多种畸形 209 个。术前小 腿外旋平均 43°,手术先截断腓骨 ,在胫骨结节下杵臼形截骨 ,远端内旋至中立位 ,测量棘、髌、踝力线正常 ,合并膝内翻、 轻度屈膝和膝反屈畸形者同时矫正 ,截骨端以外固定器或钢针交叉加石膏外固定。结果 :术后随访平均 14 个月 ,128 例 小腿外旋畸形完全矫正 ,10 例部分矫正。结论 :小腿外旋是渐进发生的常见畸形 ,胫骨结节下内旋截骨是简单有效的手 术方法 ,合并髋、膝、踝关节畸形者尽可能同期手术矫正 ,恢复下肢的持重力线。 关键词 　成年人 ; 　小腿外旋 ; 　外科治疗 ( ) 中图分类号 　R681. 2 　　　文献标识码 　A 　　　文章编号 　1005 - 8478 2001 02 - 0123 - 03 Surgical Treatment for External Rotation Deformity of Tibia in the Adult ∥QIN Sihe , S UN L ei , L I Fengcai , et al . Or thopaedic Hospital of Chaoyan g Dist rict , Beijin g 　100024 Abstract 　Objective : To explore pathogenesis and surgical treatment of external rotation deformity of the tibia in the adult ,and evaluate outcome of the treatment. Methods :A retrospective study was performed in 138 adult patients ( 144 legs) with an average age of 29. 3 ,including 116 patients secondary to poliomyelitis and 22 patients suffered from other diseases. of them ,130 cases were combined with various kinds of hip ,knee ,ankle and foot malformations to total of 209. Average preopera tive external rotation was 43 Surgical procedures were as follows :fibula was cut off firstly ,dome osteotomy under tuberosity of tibia was executed ,the distal end was turned internally to neutral position to meet normal alignment of the lower limb. Combined medial genu varum ,flexed c