先天性胫骨前脱位：一种非侵入性治疗方法

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论证。在出生后立即应用新的治疗方法的背景下，先天性胫骨前脱位的研究颇受关注。这一举措的主要目的是确保关节从生命的最早阶段就能够正常形成和功用，从而最大限度地减少脱位的后果。 这不仅是一项技术成就，也是确保先天性胫骨前脱位患儿的健康和发育获得最佳条件的 战略方法。

目的。本研究的目的是评估用一种新的专利方法治疗先天性胫骨前脱位这种罕见病症的功能效果和长期前景。

材料与方法。共对120例先天性胫骨前脱位患者（194个膝关节）进行了检查。受检患者分为主要组和对照组，主要组55例（90个膝关节），对照组65例（104个膝关节）。主治疗组的儿童使用了由作者开发的Ergopower ER 7028型振动按摩器进行治疗。对照组采用传统的胫骨前脱位矫形方法，使用冯·罗森夹板和圆形石膏模型。主治疗组患者开始治疗时的年龄为28岁[Q1 28; Q3 30]，对照组为30岁[Q1 28; Q3 34.5]。

结果。对主要治疗组和对照组儿童患者的治疗结果进行的比较分析表明，与传统技术相比，所开发的使用仪器振动按摩和细致操作矫正先天性胫骨前脱位的方法可在95%的病例中进行最准确的矫形矫正，确保恢复膝关节的轴向轮廓及其稳定性，并为成年后下肢形成和谐的生长发育类型创造条件。主要组患者在采用改良技术保守治疗先天性小腿前脱位后，经过5年的观察，观察到主组患者的膝关节功能评估优良率（66.7%）和疼痛综合征缓解率（98.2%）指标普遍优良，临床检查和专业问卷调查的数据均予以证实。

结论。通过振动大腿肌肉血管对先天性胫骨前脱位进行保守矫形的创新方法，使得在进行保守治疗时可以采用不同的方法，从而提高了总体治疗效果和长期疗效。

作者简介

Igor Yu. Kruglov

V.A. Almazov National Medical Research Center

编辑信件的主要联系方式.
Email: dr.gkruglov@gmail.com
ORCID iD: 0000-0003-1234-1390
SPIN 代码: 7777-1047
俄罗斯联邦, Saint Petersburg

Nicolai Yu. Rumyantsev

V.A. Almazov National Medical Research Center

Email: dr.rumyantsev@gmail.com
ORCID iD: 0000-0002-4956-6211
俄罗斯联邦, Saint Petersburg

Gamzat G. Omarov

North-Western State Medical University named after I.I. Mechnikov

Email: ortobaby@yandex.ru
ORCID iD: 0000-0002-9252-8130
SPIN 代码: 9565-8513

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

Sergey S. Smirnov

V.A. Almazov National Medical Research Center; Vreden National Medical Center for Traumatology and Orthopedics

Email: smirnovss_md@mail.ru
ORCID iD: 0000-0002-3210-9962
SPIN 代码: 4352-9475
俄罗斯联邦, Saint Petersburg; Saint Petersburg

Ilya M. Kagantsov

V.A. Almazov National Medical Research Center; North-Western State Medical University named after I.I. Mechnikov

Email: ilkagan@rambler.ru
ORCID iD: 0000-0002-3957-1615
SPIN 代码: 7936-8722

MD, Dr. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg; Saint Petersburg

参考

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2. Fig. 1. Congenital dislocation of the left knee and patient’s appearance

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3. Fig. 2. Treatment of a patient with congenital dislocation of the right knee using the method developed by the authors

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4. Fig. 3. Treatment outcome scale. I — correct position of the bones and knee joint flexion >120°; II — correct alignment of the bones and knee joint flexion from 90° to 120°; III — correct alignment of the bones and knee joint flexion from 50° to 90°; IVA — correct alignment of the bones and knee joint flexion from 0° to 50°; IVB — knee joint flexion up to 90° with persistent anterior subluxation of the tibia

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5. Fig. 4. Comparison of the degree of passive flexion of the tibia immediately after treatment in the main and control groups. n — is the affected limb

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6. Fig. 5. Results of assessing knee joint function in the main and control groups 5 years after treatment for CDK. n — is the affected limb

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7. Fig. 6. Treatment outcomes of congenital bilateral knee dislocation according to the method developed by the authors: a — front view of the patient; b — rear view of the patient; c — side view of the patient; d — side view of the patient with maximum flexion of the tibia

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