双平面截骨矫形并外侧解剖锁定板固定治疗成人肘内翻畸形

发布时间：2018-07-12 08:18

本文选题：肘内翻畸形 + 双平面截骨　；参考：《中国修复重建外科杂志》2017年10期

【摘要】：目的探讨肱骨远端冠状面和矢状面双平面截骨矫形并外侧解剖锁定板固定治疗成人肘内翻畸形的疗效。方法回顾分析2012年4月—2014年9月采用肱骨远端冠状面和矢状面双平面截骨并外侧解剖锁定板固定治疗的6例成人肘内翻并肘关节屈曲受限患者临床资料。其中男3例,女3例;年龄18~35岁,平均22.2岁。均有明确儿童期肘关节骨折病史,受伤年龄为2~13岁,平均6.5岁。入院检查6例患者均无神经损伤、肘关节屈伸力量异常和不稳定等并发症。术前肘关节屈曲活动度(107.50±5.24)°,伸直活动度( 12.17±3.48)°;患侧提携角为( 19.50±4.46)°,健侧提携角为(11.50±2.67)°;患侧肱骨相对健侧短缩(0.42±0.38)cm。术后随访测量肘关节屈伸活动度、提携角、双侧肱骨短缩,采用去除双肘屈伸活动度对比的改良Laupattarakasem标准评定疗效。结果术后患者切口均Ⅰ期愈合,无术后早期并发症发生。6例患者均获随访,随访时间19~27个月,平均20.8个月。随访期间无内固定物松动断裂等并发症,骨折端均于术后3个月内获得骨性愈合。末次随访时肘关节屈曲活动度为(124.17±5.85)°,伸直活动度为(0.83±2.04)°,提携角为(12.00±4.19)°,肱骨短缩为(1.88±0.45)cm,均较术前显著改善(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标准评价,优1例,良4例,可1例,优良率83.3%。结论采用双平面截骨矫形可有效矫正肘内翻畸形并改善屈曲活动度,外侧解剖锁定板固定可满足术后早期活动的稳定要求。
[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 卤5.24) 掳, and the extension range was (12.17 卤3.48) 掳, the carrying angle of the affected side was (19.50 卤4.46) 掳, the carrying angle of the normal side was (11.50 卤2.67) 掳, and the humeral relative contractility of the affected side was (0.42 卤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 卤5.85) 掳, the extension range was (0.83 卤2.04) 掳, the carrying angle was (12.00 卤4.19) 掳, and the humerus shortening was (1.88 卤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.
【作者单位】：河南省洛阳正骨医院(河南省骨科医院)上肢损伤一科;
【基金】：河南省科技攻关计划项目(152102310164)~~
【分类号】：R687.4

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