以Maguet方法做脛骨高位切開術來治療骨性膝關節炎之初步探討─七病例報告

Maquet High Tibial Osteotomy for Osteoarthritis of Knee - A Preliminary Report on Seven Cases

盧沅龍(Yean-Lung Lu) ； 謝學玄(Richard Hsieh)

《Journal of Orthopaedic Surgery Taiwan》 2卷4期 (1985/12) Pp. 204-209

摘要

高位脛骨切開術（High tibial osteotomy）於最近二十多年來已成為治療骨性膝關節炎（Osteoarthritis of the knee）常用的外科手術方法，本文報告基隆海軍醫院自1982年9月至1984年3月間，採用Maquet的方法，做高位脛骨切開術來治療骨性膝關節炎。共7病例(8個膝關節)。並經最少一年，(平均一年半的追蹤)，來做一初步的報告與探討。在這8個膝關節中，6個得到改善，1個無滿意變善，1個變差。變差這個乃因手術不佳，造成矯正過度，致仍有痛，以我們有限的經驗認為，似乎在腓骨頭下有5公分以下處作腓骨斜位開術較為簡單，亦不會傷及神經、血管，早期移除外固定器而改用支架式石膏固定，可減少釘道感染及關節僵化。若手術前能以膝關節鏡作關節內之整復，可得更好的效果。

並列摘要

High tibial osteotomy has become a main step in treating osteoarthritis of the knee in the recent decades. Keeling Naval Hospital has treated 7 case (with 8 knees involved) by Maquet Method from Sep. 1982 to Mar. 1984. We present these cases after follow up for at least one year (average 1.5 years) as a preliminary report and discussion.
Of the 8 involved knees, 6 are regarded as exceelent and good, one as fair and one as poor.
One case regarded as poor is due to over correction. She is still bothered by pain at present Our limited experience tells us that an oblique fibulotomy, 5 cm below fibular head is simple and will not injury the nerve and vessel. Early removal of external fixator (within 6 weeks after application) replaced by cast bracing could avoid pin tract infection and reduce knee joint stiffness. Better results could be achieved if debridement and trimming of knee joint was performed through arthroscope before H.T.O.

並列關鍵字

high tibial osteotomy ； H.T.O. ； osteoarthritis ； O.A.