■计算机六足辅助骨科手术(CHAOS)是一种复杂的多平面,在单个手术事件中,利用微创技术可以高精度地矫正多级畸形。这项研究的目的是报告可靠性,达到的校正精度和幅度,在整个下肢使用CHAOS技术时,患者报告的结局和并发症的危险因素。
■回顾性回顾2012年至2020年期间在三级中心接受下肢畸形矫正CHAOS的连续患者的病历和X光片。
■56例患者中有70例,48例手术部位为股骨,胫骨近端17例,胫骨远端5例。43例进行了多平面矫正,23例进行了多层截骨术。49例采用髓内钉(IMN)进行固定,21例采用锁定钢板进行固定。最大校正是40°旋转,20°日冕角度,51°矢状角和62-mm机械轴偏差(MAD)。所有患者的畸形矫正在机械上都令人满意,其中一名患者矫正不足,需要进行翻修。患者总体变化印象(PGIC)评分平均为7分的6.2分。总并发症发生率为12/70(17%)。股骨手术的并发症包括两个骨不连,一例矫正不足,一种情况下的刚度,一个肌肉疝和一个肺栓塞.胫骨手术的并发症是单室综合征,胫骨前动脉假性动脉瘤需要支架置入,一次腓总神经短暂性神经失用症,一个锁定板疲劳失效,一个血清肿和一个浅表伤口感染。
■计算机六足辅助骨科手术可用于准确矫正股骨和胫骨复杂的多水平和多平面畸形。股骨和胫骨手术的风险特征似乎有所不同,以及传统的圆形帧校正。患者对功能和症状结果都非常满意。
■法国JMR,文件方J,霍根K,etal.计算机六足辅助骨科手术矫正整个下肢多平面畸形。策略创伤肢体重建2024;19(1):9-14。
UNASSIGNED: Computerised hexapod-assisted orthopaedic surgery (CHAOS) is a method by which complex multiplanar, multilevel deformity can be corrected with a high degree of accuracy utilising minimally invasive techniques within a single operative event. This study\'s aim was to report the reliability, accuracy and magnitude of correction achieved, alongside patient-reported outcomes and risk factors for complications when using the CHAOS technique throughout the lower limb.
UNASSIGNED: Retrospective review of medical records and radiographs for consecutive patients who underwent CHAOS for lower limb deformity correction at a tertiary centre between 2012 and 2020.
UNASSIGNED: There were 70 cases in 56 patients, with the site of surgery being the femur in 48 cases, proximal tibia in 17 and distal tibia in 5 cases. Multiplanar correction was performed in 43 cases, and multilevel osteotomy was undertaken in 23 cases. Fixation was undertaken with intramedullary nailing (IMN) in 49 cases and locked plates in 21.The maximum corrections were 40° rotation, 20° coronal angulation, 51° sagittal angulation and 62-mm mechanical axis deviation (MAD). Deformity correction was mechanically satisfactory in all patients bar one who was undercorrected requiring revision. The mean patient global impression of change (PGIC) score was 6.2 out of 7.Overall complication rate was 12/70 (17%). Complications from femoral surgery included two nonunions, one case of undercorrection, one case of stiffness, one muscle hernia and one pulmonary embolism. Complications from tibial surgery were one compartment syndrome, one pseudoaneurysm of the anterior tibial artery requiring stenting, one transient neurapraxia of the common peroneal nerve, one locking plate fatigue failure, one seroma and one superficial wound infection.
UNASSIGNED: Computerised hexapod-assisted orthopaedic surgery can be used for accurate correction of complex multilevel and multiplanar deformities of both the femur and tibia. The risk profile appears to differ between femoral and tibial surgeries, and also to that of traditional circular frame correction. Patients remain highly satisfied with both the functional and symptomatic outcomes.
UNASSIGNED: French JMR, Filer J, Hogan K, et al. Computer Hexapod-assisted Orthopaedic Surgery for the Correction of Multiplanar Deformities throughout the Lower Limb. Strategies Trauma Limb Reconstr 2024;19(1):9-14.