本文選題：肘內(nèi)翻畸形 + 雙平面截骨��； 參考：《中國修復(fù)重建外科雜志》2017年10期

【摘要】：目的探討肱骨遠端冠狀面和矢狀面雙平面截骨矯形并外側(cè)解剖鎖定板固定治療成人肘內(nèi)翻畸形的療效。方法回顧分析2012年4月—2014年9月采用肱骨遠端冠狀面和矢狀面雙平面截骨并外側(cè)解剖鎖定板固定治療的6例成人肘內(nèi)翻并肘關(guān)節(jié)屈曲受限患者臨床資料。其中男3例,女3例;年齡18~35歲,平均22.2歲。均有明確兒童期肘關(guān)節(jié)骨折病史,受傷年齡為2~13歲,平均6.5歲。入院檢查6例患者均無神經(jīng)損傷、肘關(guān)節(jié)屈伸力量異常和不穩(wěn)定等并發(fā)癥。術(shù)前肘關(guān)節(jié)屈曲活動度(107.50±5.24)°,伸直活動度( 12.17±3.48)°;患側(cè)提攜角為( 19.50±4.46)°,健側(cè)提攜角為(11.50±2.67)°;患側(cè)肱骨相對健側(cè)短縮(0.42±0.38)cm。術(shù)后隨訪測量肘關(guān)節(jié)屈伸活動度、提攜角、雙側(cè)肱骨短縮,采用去除雙肘屈伸活動度對比的改良Laupattarakasem標(biāo)準(zhǔn)評定療效。結(jié)果術(shù)后患者切口均Ⅰ期愈合,無術(shù)后早期并發(fā)癥發(fā)生。6例患者均獲隨訪,隨訪時間19~27個月,平均20.8個月。隨訪期間無內(nèi)固定物松動斷裂等并發(fā)癥,骨折端均于術(shù)后3個月內(nèi)獲得骨性愈合。末次隨訪時肘關(guān)節(jié)屈曲活動度為(124.17±5.85)°,伸直活動度為(0.83±2.04)°,提攜角為(12.00±4.19)°,肱骨短縮為(1.88±0.45)cm,均較術(shù)前顯著改善(t= 6.742,P=0.001;t= 11.068,P=0.000;t= 20.400,P=0.000;t= 13.914,P=0.000)。按照改良Laupattarakasem標(biāo)準(zhǔn)評價,優(yōu)1例,良4例,可1例,優(yōu)良率83.3%。結(jié)論采用雙平面截骨矯形可有效矯正肘內(nèi)翻畸形并改善屈曲活動度,外側(cè)解剖鎖定板固定可滿足術(shù)后早期活動的穩(wěn)定要求。
[Abstract]:Objective to investigate the effect of bilateral osteotomy and lateral anatomic locking plate fixation in the treatment of elbow varus deformity in adults. Methods from April 2012 to September 2014, the clinical data of 6 adult patients with elbow varus and limited flexion of elbow joint were retrospectively analyzed, who were treated with bilateral osteotomy of distal humerus and sagittal plane osteotomy with lateral anatomic locking plate. There were 3 males and 3 females, aged 1835 years with an average age of 22.2 years. All of them had a clear history of elbow fracture in childhood. The age of injury was 2 to 13 years (mean 6.5 years). No nerve injury, abnormal flexion and extension strength and instability of elbow joint were found in 6 patients. The flexion and motion of elbow joint were (107.50 鹵5.24) 擄, and the extension range was (12.17 鹵3.48) 擄, the carrying angle of the affected side was (19.50 鹵4.46) 擄, the carrying angle of the normal side was (11.50 鹵2.67) 擄, and the humeral relative contractility of the affected side was (0.42 鹵0.38) cm. The flexion and extension of elbow joint, carrying angle and humerus shortening were measured after operation. The modified Laupattarakasem standard was used to evaluate the curative effect. Results all the incisions healed in the first stage. All the patients were followed up without early postoperative complications. The follow-up time was 19 ~ 27 months (mean 20.8 months). There were no complications such as loosening and fracture of internal fixation during follow-up. Bone healing was achieved at the end of fracture within 3 months after operation. At the last follow-up, the flexion and motion of the elbow joint were (124.17 鹵5.85) 擄, the extension range was (0.83 鹵2.04) 擄, the carrying angle was (12.00 鹵4.19) 擄, and the humerus shortening was (1.88 鹵0.45) cm, which was significantly improved compared with the preoperative values (t = 6.742P0.001t = 11.068P0.000t = 20.400m P0. 000t = 13.914p 0.000). According to the modified Laupattarakasem criterion, 1 case was excellent, 4 good and 1 fair. The excellent and good rate was 83.3%. Conclusion Biplane osteotomy can effectively correct cubitus varus deformity and improve flexion and motion. The lateral anatomic locking plate fixation can meet the requirements of stability of early postoperative activities.
【作者單位】： 河南省洛陽正骨醫(yī)院(河南省骨科醫(yī)院)上肢損傷一科;
【基金】：河南省科技攻關(guān)計劃項目(152102310164)~~
【分類號】：R687.4

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本文編號：2116546