肱骨髁上楔形截骨钢板内固定治疗儿童肘内翻畸形  

Supracondylar Wdege Osteotomy and Internal Fixation with Reconstrucation Plate for Cubitus Varus

作　　者：朱小华[1] 邓志成[1] 莫广宁[1] 郭胜[1] 许国泰[1] 

机构地区：[1]南方医科大学附属小榄医院骨二科,广东中山528415

出　　处：《实用骨科杂志》2013年第4期297-299,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨并总结运用重建钢板治疗儿童肘内翻畸形的临床疗效。方法回顾分析南方医科大学附属小榄医院2005年6月至2011年7月采用外侧肱骨髁上楔形截骨重建钢板内固定治疗的肘内翻畸形患儿31例,男18例,女13例;年龄6～14岁,平均8.39岁。肘内翻角度25.4°(17°～31°)。结果所有患儿术后畸形矫正良好,获得平均6.2°(3°～20°)提携角。术前与术后提携角比较,有统计学差异(t=1.925,P<0.05)。术后关节活动范围平均125°(90°～135°),与术前相比无明显改变。术后随访时间1～3年(平均2.6年),无一例复发,无骨化性肌炎发生。所有病例均无血管损伤、感染等并发症发生,术后肌力正常,1例并发尺神经损伤,经保守治疗2个月后改善,2例旋转轻度障碍,14例肱骨外髁处出现隆起。肱骨截骨处平均骨性愈合时间为3.4个月(3～4个月),所有病例均未出现内固定松动现象,拆除内固定时间为15个月(8～18个月)。结论尽管侧方肱骨髁上楔形截骨重建钢板内固定治疗儿童肘内翻畸形可能发生肱骨远端外侧突起、肘关节外侧瘢痕等并发症,但是术后总体疗效满意,是一种可以广泛应用的术式。Objective To analyse and summarize the therapeutic effect of supracondylar wedge osteotomy and in- ternal fixation wih reconstruction plate for eubitus varus in children. Methods 31 children with cubitus varus were retrospectively analyzed,who were treated with supraeondylar wedge osteotomy and internal fixation wih reconstruc- tion plate in our department from June 2005 to July 2011. There were 17 left arms,14 right. And the angle was be- tween 17° to 31°,with an average of 25.4°. Results All deformities were corrected. There were an average of 6.2°（3° ~20°）carrying angle according to postoperative X-ray. Compared with preoperative carrying angle,the difference was statistically significant （t= 1. 925 ,P〈0.05）. The average range of motion of elbow joint was 125°（90°~135°） ,there were no significant changes compared with the preoperative conditions. The follow-up time was 1~3 years （average 2.6 years） after osteotomy. There were no recurrent deformity,myositis ossificans ,vessels damage and infection hap- pened. The muscle strength was normal. The symptom of ulnar nerve injured case was improved after 2 months＇ con- servative treatment. 2 cases had a little rotation disorder, 14 cases had prominences on the lateral condyle. The average healing time of humerus osteotomies was 3.4 months （3~ 4 months）,with no looseness happened ,the internal fixation was removed 15 months （8~ 18 months） after operation. Conclusion Despite with the complications of distal humerus prominence and lateral scar,the supracondylar wedge osteotomy and internal fixation wih reconstruction plate for cuhitus varus in children can provide satisfactory overall results ,and should he widely used.

关 键 词：肘内翻 楔形截骨 重建钢板 肱骨髁上截骨 儿童 

分 类 号：R682.5[医药卫生—骨科学]