Surfix lock plate system®を用いたHTO術後早期荷重の効果

Effects of Early Weight Bearing after High Tibial Osteotomy (HTO) with the Surfix Lock Plate System®

　抄録：［目的］高位けい骨骨切り術（HTO）において従来の内固定材料を用いての術後早期荷重では矯正角度を減じ，疼痛の再燃や長期予後不良の結果がもたらされる．Surfix lock plate system^®では特殊なねじ付きプラグで螺子をプレートに固定し，その強固な内固定力で術後早期荷重を可能にした．国内で使用可能となった昨年10月以来の症例を検証した．

［対象と方法］HTOの一方法であるinterlocking wedge osteotomyを行い，術後半年以上を経過した14症例14膝（手術時年齢平均66歳．関節症10膝，膝骨壊死4膝）について，それ以前のblade stapleを用いた症例と比較検討した．

［結果］術後簡易膝固定装具を装着させ，数日後から1/3部分荷重，CPM可動訓練を開始し，徐々に荷重量を増やした．治療成績は良好で，以前の症例より平均在院日数は大幅に短縮でき，職場復帰や家事への復帰も短縮できた．

　Early weight bearing after high tibial osteotomy (HTO) with the use of traditional internal fixation devices for medial compartment osteoarthritis and osteonecrosis of the knee leads to loss of correction of the angulation. The correction loss causes recurrence of the knee pain and poor long-term results.

　The newly designed Surfix lock plate system^® uses a set screw to fix the screw on the plate. Fixation for the bone is simple and provides cement-like stability that is as strong as obtained with external fixation devices. Surer reported the reliability of this device for HTO (1997).

　We started using this new device for interlocking wedge osteotomy (Ogata) in October in 2002 and have assessed the results in the first fourteen patients. Use of the new device caused no loss of correction as a result of early weight bearing after surgery. It shortened the length of the patients' hospital stay, and the patients returned to work within a short tine.