| 赵春超,李大为,黎立.微创截骨结合应用锁定钢板手术治疗儿童尺桡骨远端畸形愈合[J].安徽医药,2020,24(4):787-790. |
| 微创截骨结合应用锁定钢板手术治疗儿童尺桡骨远端畸形愈合 |
| Minimally invasive osteotomy combined with locking plate surgery for healing of distal ulnar and radius deformities in children |
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| DOI：10.3969/j.issn.1009?6469.2020.04.038 |
| 中文关键词: 桡骨骨折 尺骨骨折 关节畸形，获得性 截骨术 骨板 骨折固定术，内 儿童 |
| 英文关键词: Radius fractures Ulna fractures Joint deformities,acquired Osteotomy Bone plates Fracture fixation,in?ternal Child |
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| 中文摘要: |
| 目的探讨微创截骨结合应用锁定钢板治疗儿童尺桡骨远端畸形愈合的临床疗效。方法分析 2014年 6月至 2018年 12月期间在山东中医药大学附属医院小儿骨科收集的儿童尺桡骨远端骨折畸形愈合 19例，男 12例，女 7例；年龄范围为 7～14岁，手术距初次损伤时间范围为 28～65 d。其中 9例尺桡骨均存在明显畸形愈合， 10例尺骨骨折愈合对位对线良好。桡骨矢状面成角畸形范围为 39°～53°，平均桡骨矢状面成角畸形 45°；冠状位成角畸形范围为 31°～47°，平均冠状位成角畸形 39°，全部按照微创截骨结合应用锁定钢板手术治疗并行前臂 U形石膏托固定 6周。结果病儿术前腕关节背伸( 49.74±12.14)°、掌屈( 61.42±11.52)°、尺偏( 22.68±7.56)°、桡偏( 9.21±2.66)°，末次随访时腕关节背伸( 78.68±5.43)°、掌屈( 88.79±2.12)°、尺偏(52.21±2.49)°、桡偏( 24.11±1.20)°，末次随访与术前相比差异有统计学意义(均 P＜0.05)。末次随访时拍摄双前臂全长正侧位 DR，桡骨的掌倾角与尺偏角患侧与健侧比较差异无统计学意义(均 P＞0.05)。按照 Cooney腕关节评分标准:优 17例，良 2例。 19例病儿均获得良好的骨性愈合，尺桡骨的长度关系及成角均获得良好恢复。结论微创截骨结合应用锁定钢板手术治疗儿童尺桡骨远端陈旧性骨折疗效显著，术后恢复效果好，短期内达到矫正前臂及腕关节畸形功能活动障碍的目的。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy of minimally invasive osteotomy combined with locking plate in the treat?ment of distal ulnar and radial deformity in children.Methods Retrospective analysis of 19 cases of deformity of distal radius frac?tures of children were collected in Department of Pediatric Orthopedics，The Affiliated Hospital of Shandong University of Tradition? al Chinese Medicine，during the undergraduate and graduate levels from June 2014 to December 2018.All patients have 12 malesand 7 females; the age of 7～14 years old，an average of 9.6 years old，the surgery from the initial injury time of 28 days to 65 days，an average of 38 days.Among them，9 cases of ulnar humerus had obvious malunion healing，and 10 cases of ulnar fracture healing were in good alignment.The sagittal horn of the humerus was 39°～53°，with an average of 45°；the coronal deformity was 31°～47°，with an average of 39°.All the patients were treated with minimally invasive osteotomy combined with locking plate forthe treatment of the forearm U?shaped plaster support and fixed for 6 weeks.Results Before the operation，the wrist dorsiflexion was(49.74±12.14)°，the palm flexion was(61.42±11.52)°，the ulnar deviation was(22.68±7.56)°，and the radial deviation was(9.21±2.66)°.At the last follow?up，the wrist dorsiflexion was(78.68±5.43)°，the palm flexion was(88.79±2.12)°，the ulnar devia? tion was(52.21±2.49)°，and the radial deviation was(24.11±1.20)°，the difference between the last follow?up and preoperative was statistically significant (all P＜0.05).At the last follow?up，the full?length positive lateral DR of the double forearm was taken.Therewas no significant difference in the metatarsal angle of the tibia and the ulnar angle between the affected side and the healthy side(all P＞0.05).According to the Cooney wrist score: excellent in 17 cases and good in 2 cases.All the 19 patients achieved good bone healing，and the length relationship and angle of the ulnar and radial bones were well restored.Conclusion Minimally inva?sive osteotomy combined with locking plate operation for the treatment of old fractures of the distal radius and ulna of children hassignificant curative effect.The postoperative recovery effect is good，and the purpose of correcting forearm and wrist joint malforma?tion dysfunction is achieved in a short period of time. |
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