小児下肢回旋変形に対する経皮的下腿回旋骨切り術の経験

Percutaneous Rotational Osteotomy of the Distal Tibia and Fibula in Children with Rotational Deformities of the Lower Extremities

　小児下肢回旋変形に対する下腿遠位での経皮的回旋骨切り術について報告する．症例は5例8肢（内旋歩行1例2肢，外旋歩行1例1肢，二分脊椎に伴う下肢内旋変形3例5肢）である．これらの症例に対してドリルを用いたcorticotomyとKワイヤー固定による下腿遠位での経皮的回旋骨切り術を行った．手術時年齢は9～14歳（平均11歳）であった．全症例で矯正に伴い立位姿勢，歩容の改善を認め，重篤な合併症はなかった．われわれが用いた経皮的回旋骨切り術は簡便であり手術創も小さく美容的観点からも優れた手術法と思われた．

　We performed percutaneous distal tibial and fibular rotational osteotomy in five children (eight limbs)：one (two limbs) with in-toeing gait, one (one limb) with out-toeing gait, and three patients (five limbs) with internal rotational deformities secondary to myelomeningocele. We performed corticotomy of the distal tibia and fibula with a drill through a small incision and fixed the tibia with Kirschner wires. Age at the time of the operation ranged from nine to 14 years (mean：11 years). All patients had good results with no severe complications. We conclude that our procedure for correcting tibial rotational deformities is not only effective and simple, but good from a cosmetic standpoint as well.