B. J. Page, Michael D. Greenstein, Gerard A Sheridan, A. Fragomen, S. Rozbruch
{"title":"关节外截骨术治疗胫骨平台关节内翻转畸形","authors":"B. J. Page, Michael D. Greenstein, Gerard A Sheridan, A. Fragomen, S. Rozbruch","doi":"10.1097/bot.0000000000002845","DOIUrl":null,"url":null,"abstract":"\n \n To report a case series of extra-articular osteotomies for the management of intra-articular tibial plateau malunions and to assess the ability to correct deformity and improve knee range of motion (ROM).\n \n \n \n \n \n \n Retrospective case series\n \n \n \n Academic, tertiary, referral center.\n \n \n \n Adult patients with tibial plateau fracture malunion treated with extra-articular osteotomy of the femur and/or tibia between 2014-2023.\n Outcome Measures and Comparison: Mechanical axis deviation (MAD), medial proximal tibia angle (MPTA), lateral distal femoral angle (LDFA), and posterior proximal tibia angle (PPTA) correction; knee ROM, and time to weight bearing.\n \n \n \n There were 7 patients included, 6 (85.7%) were female and 1 (14.3%) were male. The median age was 43.5 years (IQR 38.5-51, range 32-62). Four (57.1%) patients were treated with a high tibial osteotomy (HTO) and 3 (42.9%) patients were treated with an HTO and distal femoral osteotomy (DFO). One patient had concomitant supramalleolar osteotomy with HTO to address distal tibia procurvatum and valgus. Four were treated with hexapod frames and 3 were treated with plates and screws. Median follow-up was 22.5 months (IQR 10.5-107 months, range 7-148 months).\n Surgical intervention corrected median radiographic measures of valgus malalignment pre-operatively relative to post-operative values. This included MAD (42.5mm to 0mm), valgus angle (12.5° to 1.5°), MPTA (95° to 88.0°), and LDFA 86.0° to 87.3°). Surgical intervention increased maximal knee range of motion pre- to post-operatively.\n Median time to full weight bearing was 81.5 days (IQR 46-57 days, range 41-184 days Two patients were converted to total knee arthroplasty after 5 and 10 years following HTO with hexapod frame.\n \n \n \n Extra-articular osteotomy is an effective treatment for addressing intra-articular malunion after tibia plateau fractures. It is effective in correcting the MAD, valgus deformity, MPTA, LDFA, PPTA, and improving knee ROM (measured through knee extension and flexion).\n \n \n \n Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.\n","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Extra-articular Osteotomy for the Management of Intra-articular Tibial Plateau Valgus Malunion\",\"authors\":\"B. J. Page, Michael D. Greenstein, Gerard A Sheridan, A. Fragomen, S. Rozbruch\",\"doi\":\"10.1097/bot.0000000000002845\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n To report a case series of extra-articular osteotomies for the management of intra-articular tibial plateau malunions and to assess the ability to correct deformity and improve knee range of motion (ROM).\\n \\n \\n \\n \\n \\n \\n Retrospective case series\\n \\n \\n \\n Academic, tertiary, referral center.\\n \\n \\n \\n Adult patients with tibial plateau fracture malunion treated with extra-articular osteotomy of the femur and/or tibia between 2014-2023.\\n Outcome Measures and Comparison: Mechanical axis deviation (MAD), medial proximal tibia angle (MPTA), lateral distal femoral angle (LDFA), and posterior proximal tibia angle (PPTA) correction; knee ROM, and time to weight bearing.\\n \\n \\n \\n There were 7 patients included, 6 (85.7%) were female and 1 (14.3%) were male. The median age was 43.5 years (IQR 38.5-51, range 32-62). Four (57.1%) patients were treated with a high tibial osteotomy (HTO) and 3 (42.9%) patients were treated with an HTO and distal femoral osteotomy (DFO). One patient had concomitant supramalleolar osteotomy with HTO to address distal tibia procurvatum and valgus. Four were treated with hexapod frames and 3 were treated with plates and screws. Median follow-up was 22.5 months (IQR 10.5-107 months, range 7-148 months).\\n Surgical intervention corrected median radiographic measures of valgus malalignment pre-operatively relative to post-operative values. This included MAD (42.5mm to 0mm), valgus angle (12.5° to 1.5°), MPTA (95° to 88.0°), and LDFA 86.0° to 87.3°). Surgical intervention increased maximal knee range of motion pre- to post-operatively.\\n Median time to full weight bearing was 81.5 days (IQR 46-57 days, range 41-184 days Two patients were converted to total knee arthroplasty after 5 and 10 years following HTO with hexapod frame.\\n \\n \\n \\n Extra-articular osteotomy is an effective treatment for addressing intra-articular malunion after tibia plateau fractures. It is effective in correcting the MAD, valgus deformity, MPTA, LDFA, PPTA, and improving knee ROM (measured through knee extension and flexion).\\n \\n \\n \\n Therapeutic Level IV. 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Extra-articular Osteotomy for the Management of Intra-articular Tibial Plateau Valgus Malunion
To report a case series of extra-articular osteotomies for the management of intra-articular tibial plateau malunions and to assess the ability to correct deformity and improve knee range of motion (ROM).
Retrospective case series
Academic, tertiary, referral center.
Adult patients with tibial plateau fracture malunion treated with extra-articular osteotomy of the femur and/or tibia between 2014-2023.
Outcome Measures and Comparison: Mechanical axis deviation (MAD), medial proximal tibia angle (MPTA), lateral distal femoral angle (LDFA), and posterior proximal tibia angle (PPTA) correction; knee ROM, and time to weight bearing.
There were 7 patients included, 6 (85.7%) were female and 1 (14.3%) were male. The median age was 43.5 years (IQR 38.5-51, range 32-62). Four (57.1%) patients were treated with a high tibial osteotomy (HTO) and 3 (42.9%) patients were treated with an HTO and distal femoral osteotomy (DFO). One patient had concomitant supramalleolar osteotomy with HTO to address distal tibia procurvatum and valgus. Four were treated with hexapod frames and 3 were treated with plates and screws. Median follow-up was 22.5 months (IQR 10.5-107 months, range 7-148 months).
Surgical intervention corrected median radiographic measures of valgus malalignment pre-operatively relative to post-operative values. This included MAD (42.5mm to 0mm), valgus angle (12.5° to 1.5°), MPTA (95° to 88.0°), and LDFA 86.0° to 87.3°). Surgical intervention increased maximal knee range of motion pre- to post-operatively.
Median time to full weight bearing was 81.5 days (IQR 46-57 days, range 41-184 days Two patients were converted to total knee arthroplasty after 5 and 10 years following HTO with hexapod frame.
Extra-articular osteotomy is an effective treatment for addressing intra-articular malunion after tibia plateau fractures. It is effective in correcting the MAD, valgus deformity, MPTA, LDFA, PPTA, and improving knee ROM (measured through knee extension and flexion).
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
期刊介绍:
Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.