尺骨截骨及外固定架联合治疗儿童陈旧性桡骨小头前脱位  

Ulnar osteotomy and external fixation for chronic anterior dislocation of head of the radius in children

作　　者：罗永忠[1] 李佩佳[1] 赵汉平[1] 刘明[1] 骆刚[1] 史庆轩[1] 

机构地区：[1]解放军第88医院全军骨科中心,山东泰安271000

出　　处：《中国矫形外科杂志》2006年第4期266-268,共3页Orthopedic Journal of China

摘　　要：[目的]探讨儿童桡骨小头陈旧性脱位的手术方法。[方法]对13例陈旧性桡骨小头前脱位病人采用尺骨上段截骨及外固定支架固定、桡骨小头闭合或切开复位、但不修复环状韧带进行治疗，平均年龄5．5岁（2～11岁），从受伤到手术时间为4个月～5a，平均19个月。所有病人均无桡神经损伤，无桡骨小头变形。[结果]术后平均随访时间14个月（2个月～3a），所有桡骨小头均维持良好复位，12例病人术后关节活动较术前改善，或与术前一致；1例术后旋后功能较术前减小10°。1例术后浅部钉眼感染。[结论]利用外固定支架固定尺骨截骨端可调整到使桡骨小头在任意方向的稳定性，该方法具有手术简单、并发症少、术后关节功能恢复快等优点，是一种可推荐的治疗方法。[ Objective ] To evaluated the clinical results of the ulnar osteotomy and external fixation for the treatment of chronic anterior dislocation of head of the radius in children. [ Method ] From 2002 to 2004, thirteen cases of children with chronic anterior dislocation of the radial head were treated by ulnar osteotomy, external fixation and close or open reduction of elbow joint but without repair of the annular ligament. Their mean age was 5.5 years（2 to 11 ） and the mean interval between the injury and reconstruction was 19 months （2 months to 3 years）. [ Result] All radial heads remained reduced at a mean follow-up of 14 months（ 2 months to 3 years）. Normal ranges of movement for flexion, extension, pronation and supination were improved or unchanged in 12 patients. One patient had further decreased in 10° for supination. There were one superficial pin-track infections but with no serious complication. [ Conclusion] Angular ulnar osteotomy and external fixation of the ulna can lead to stable reduction of the radial head with minimal complications. Reconstruction of the annular ligament is not necessary if satisfactory re-o- rientation of the ulnar is achieved in all planes.

关 键 词：儿童陈旧性桡骨小头脱位 尺骨截骨 外固定支架 

分 类 号：R726.8[医药卫生—儿科]