短缩、旋转截骨术治疗儿童先天性上尺桡关节融合  

Shortening and derotation osteotomy for congenital radioulnar synostosis in children

作　　者：梅海波[1] 赫荣国[1] 刘昆[1] 伍江雁[1] 唐进[1] 叶卫华[1] 胡欣[1] 

机构地区：[1]湖南省儿童医院骨科,长沙410007

出　　处：《中华小儿外科杂志》2008年第9期553-556,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的介绍上尺桡关节骨性融合处的短缩、旋转截骨术治疗儿童先天性上尺桡关节融合的手术方法，并评价其初步疗效。方法对本院2002年来治疗的6例（8个肢体）先天性上尺桡关节融合的患儿，进行尺桡骨近端骨性联接处的短缩、旋转截骨术，Ⅰ期旋转至所需位置，交叉克氏针固定，屈肘位石膏固定6～8周。6～8周后拆石膏、拔克氏针，开始主动肘关节功能训练。结果6例（8个肢体）随访1年2个月45年，平均2．3年，6例中1例1侧术后发生轻度缺血性肌挛缩，其余病例均未出现并发症，术后8周截骨处达骨性愈合，患肢功能满意。结论该术式手术操作简单，可以有效避免术后并发症的发生，是治疗先天性上尺桡关节融合的较理想的方法。Objective To describe a new procedure of shortening and derotation osteotomy for congenital proximal radioulnar synostosis and its clinical efficacy in children. Methods Six cases （8 joints） with congenital proximal radioulnar synostosis in children were undertaken shortening and derotation osteotomy at the radioulnar syiaostosis. The bones were placed in a functional position and fixed by two Kirschner wires to maintain skeletal stability. The elbow joints were immobilized in cast for 6-8 weeks after the operation. After 6-8 weeks, the cast and the wires were removed. Results Five cases （7 joints） were followed up for 18-60 months （average 28 months）. Except 1 patient got ischemie contraeture, the others had satisfactory limb functions. All of the shortening and derotation osteotomies at the radioulnar synostosis healed uneventfully. Conclusions Compared with the der otional osteotomy of proximal radioulnar synostosis or other derotional ostotomy, the shortening and derotation osteotomy might perform easily with fewer complications. This procedure is suitable for treatment of congenital proximal radioulnar synostosis.

关 键 词：关节 畸形 截骨术 

分 类 号：R687.3[医药卫生—骨科学]