尺骨延长治疗儿童多发性骨软骨瘤所致前臂畸形26例  

Lengthening the ulna by the Ilizarov technique in patients with multiple exostoses.

作　　者：孙琳[1] 郭东[1] 孙保胜[1] 于凤章[1] 张学军[1] 李成鑫[1] 祁新禹[1] 潘少川[1] 

机构地区：[1]首都医科大学附属北京儿童医院外科骨科专业组,100045

出　　处：《临床小儿外科杂志》2009年第3期14-16,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的总结26例因多发性骨软骨瘤导致前臂畸形的手术治疗经验，探讨手术的安全性、疗效及注意事项。方法采用尺骨截骨Ilizarov技术和骨外固定器逐渐延长尺骨，矫正弯曲，同时牵引桡骨小头复位。在治疗过程中，始终进行腕关节、掌指关节和指间关节的屈伸功能锻炼，尤其是伸直功能锻炼。结果8例前臂短缩、弯曲得到矫正，肘内翻、腕关节尺偏纠正，外观满意。前臂旋转功能较术前改善，旋前增加10°-16°，旋后增加11°-14°。1例发生暂时性桡神经麻痹，1例发生肘关节功能障碍，2例低龄患儿出现指间关节屈曲，并发症的发生率为15％。结论采用尺骨延长术治疗多发性骨软骨瘤所致的前臂畸形具有改善外观和功能的作用。治疗期间应注意肘关节、腕关节、掌指关节和指问关节的康复训练，尤其是低龄儿童。Objective A retrospective case review ：26 cases of ulna lengthening by the llizarov outer fixitor in multiple exostoses of the forearm.To determine the safety and effectiveness of this technique. Methods The shortening and bowing ulna was lengthened,the radial-head dislocation was reduced by the Ilizarov technique gradually.The motion exercise of elbow joint,wrist joint,mataearpal-phalanx joint and interphalanx joint should be done during the whole treatment period. Results the forearm deformity was corrected aesthetically, function of forearm improved, pronation increased 10°-16°, supination increased 11°-14°.During the treatment period,complications occurred in 4 of the 26 patients （15%）. Conclusions Based on our experiences,the forearm deformity and function could be markedly improved by the ulnar lengthening with Ilizarov＇s procedure; the joint motion exercise should be emphasized, especially in the young children.

关 键 词：尺骨/外科学 外生骨疣 多发性遗传性 前臂/畸形 

分 类 号：R738.3[医药卫生—肿瘤] R682.5[医药卫生—临床医学]