计算机辅助单一斜形旋转截骨矫正股骨多平面畸形△

Computer-assisted oblique single-cut rotation osteotomy for correction of multiplanar deformity of the femur

摘要:

［目的］介绍斜形单平面旋转截骨术矫正股骨多平面畸形的手术技术和初步临床效果。［方法］对 1 例股骨骨折畸形愈合患者行上述手术治疗。进行术前设计，确定截骨角度和旋转角度，在 Mimics 软件上模拟手术，3D 打印制作截骨导板，对该病例行斜形单平面旋转截骨手术治疗。取股骨外侧纵行切口，显露畸形部位，安放截骨导板，按术前设计完成截骨、旋转， 截骨断端用髓内钉固定，断端取髂骨植骨。［结果］手术过程顺利，术后无不良并发症，术后 6 个月复查，无跛行，膝关节无疼痛，CT 证实骨断端完全愈合。［结论］ 斜形单平面旋转截骨术切实可行，一次截骨同时矫正股骨在冠状面、矢状面和旋转畸形，短期可取得满意的临床疗效。

Abstract:

[Objective] To introduce the preoperative design, surgical technique and preliminary clinical outcome of oblique single-cut rotation osteotomy for correction of multiplanar deformity of the femoral shaft. [Methods] A patient received abovementioned surgical treat- ment for malunion of femoral shaft fracture. Preoperative design was conducted to determine the osteotomy angle and rotation angle by com- puter, and then the operation was simulated on Mimics software, and the osteotomy guider was made by 3D printing. A longitudinal incision was made on the lateral side of the femur to expose the malunion part of the femur. The osteotomy guider was placed, and the osteotomy and rotation of the bone ends were completed according to the preoperative design, subsequently, an interlocking intramedullary nail was used to fix the osteotomy in corrected alignment with bone autograft harvesting from the iliac create around the osteotomy site. [Results] The opera- tion was performed smoothly without adverse reaction and complications. After 6 months of follow-up, the patient had no longer limping, and no pain in the knee. The CT images confirmed that the osteotomized site healed completely. [Conclusion] This oblique single-cut rotation osteotomy is feasible to correct the angulations in the coronal and sagittal planes and rotational deformities in transverse plane of the femur si- multaneously, with satisfactory short-term clinical outcome.