胫骨高位截骨槽式钢板内固定治疗膝关节骨性关节炎并膝内翻

目的：总结应用Link槽式钢板的胫骨高位截骨术（HTO）治疗膝关节骨性关节炎并膝内翻的疗效。方法：1999年3月-2002年12月总共18例膝关节骨性关节炎并膝内翻患者接受HTO并应用Link槽式钢板内固定，其中男性3例，女性15例，年龄最大62岁，最小43岁（平均51岁），膝内翻角度最大24°，最小8°（平均17°），HSS膝关节评分甲均71分。结果：全部病例术后随访最长3年，最短6个月（平均25个月），均获得骨性愈合，截骨处无移位及松动，内固定无断裂，膝关节屈伸活动度同术前，纠正膝内翻角度平均22°，股胫角（胛A）平均达到外翻9°，HSS膝关节计分半均为86分，较术前增加15分。1例患者术后出现腓总神经牵拉症状，2月后消失。1例患者术后因脂肪液化伤口延迟愈合，换药后痊愈。结论：HTO可明显改善骨性关节炎并膝内翻患者的下肢负重轴线及局部血供，降低骨内瓜，疗效满意。Link槽式钢板设计简单，固定可靠，截骨角度可准确掌握，是HTO理想的内固定选择。

Treatment of Knee Osteoarthritis by High Tibial Osteotomy with Link Giebel Blade Plates

Objective： To summarize the effects of high fibial osteotomy （HTO） with Link giebel blade plates internal fixation in the treatment of knee osteoarthritis （OA） combined with genu varum. Methods： From March 1999 to December 2002, 18 cases of knee OA combined with genu varum were underwent HTO by using Link gihel blade plates. Among them, there are 3 male and 15 female, aging from 43 to 62 years （average 51 years）, and the angel of gene varum were from 8° to 22°（average 17°）. The mean score was 71 according to HSS knee joint standard. Results： All cases were followed-up from 6 months to 3 years （average 25 months） postopratively and obtained a bone union. Range of motion of the knee joint was the same as preoperation. The correction angel of genu varum was mean 22°, FTA achieved to 9° of eversion. The mean score was 86 according to HSS standard, which had increased by 15 than preoprafion. Conclusion： HTO can apparently correct the weight loading axis of knee OA combined with genu varum, improve the local blood supply and decrease the pressure in the tibia. Link gibel blade plates have an advantages of simple design, reliable fixation and control the osteotomy angle accurately. It is an ideal choice of internal fixation for HTO.