应用保留桡骨头桡骨颈节段性截骨治疗创伤后上尺桡关节骨性融合的早期疗效  

Early outcomes of the segmental osteotomy of radial neck with the radial head preserved for treatment of post-traumatic proximal radioulnar synostosis

作　　者：黎逢峰 芮永军[2] 黄彦[1] 曹燕明[1] Li Fengfeng;Rui Yongjun;Huang Yan;Cao Yanming(Department of Orthopedic Trauma,the 2 nd Hospital Affiliated to Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院创伤骨科,510260 [2]苏州大学附属无锡九院创伤骨科,214062

出　　处：《骨科临床与研究杂志》2020年第2期116-121,共6页Journal Of Clinical Orthopedics And Research

基　　金：国家自然科学基金面上项目(81873996)~~

摘　　要：目的探讨保留桡骨头的桡骨颈节段性截骨治疗创伤后上尺桡关节骨性融合的早期疗效。方法回顾分析2017年1月至2019年5月广州医科大学附属第二医院创伤骨科采用保留桡骨头的桡骨颈节段性截骨术治疗的创伤性上尺桡关节骨性融合患者7例的临床资料。其中男5例,女2例;年龄为(35±11)岁(19~60岁)。患肢均为右侧。评价术前与随访时患肢前臂旋转活动度、肘和腕关节疼痛程度、握力以及尺骨变异程度和截骨处异位骨化情况并进行比较。采用SPSS 18.0软件对数据进行处理。结果随访(4±0.4)个月(2~6个月)。术前与术后3个月前臂旋转活动度分别为(43±14)°(15°~51°)和(120±31)°(111°~134°),差异有统计学意义(P=0.012);握力分别为(25.5±10.3)kg(21.2~28.6 kg)和(26.3±11.1)kg(21.7~28.4 kg),差异无统计学意义(P=0.074);尺骨变异分别为(-0.13±0.04)mm(-0.15^-0.07 mm)和(-0.12±0.09)mm(-0.14^-0.08 mm),差异无统计学意义(P=0.081)。所有患者术前与术后肘关节与腕关节未见疼痛,术后未见截骨处异位骨化形成。结论应用保留桡骨头的桡骨颈节段性截骨治疗创伤后上尺桡关节骨性融合,方法简单,早期疗效令人满意。Objective To investigate the early outcomes of the segmental osteotomy of radial neck with the radial head preserved for treatment of post-traumatic proximal radioulnar synostosis. Methods Seven patients with synostosis of the upper radioulnar joint were treated by segmental osteotomy of the neck of the radius with the radius head preserved in Department of Orthopedic Trauma of the 2 nd Hospital Affiliated to Guangzhou Medical University from January 2017 to May 2019. There were 5 males and 2 femals. The age was(35±11) years(19-60 years). All the affected limbs were on the right side. The preoperative and postoperative forearm rotation activity, elbow and wrist pain, grip strength, the relative position of the distal radioulnar joint and heterotopic ossification of osteotomy site were evaluated and compared by SPSS 18.0. Results The follow-up duration was(4±0.4) months(2-6 months). The forearm rotation activity at preoperation and 3 months postoperatively were(43±14)°(15°-51°)and(120±31)°(111°-134°) respectively, and the difference was statistically significant(P=0.012). Preoperative and postoperative grip power were(25.5±10.3) kg(21.2-28.6 kg) and(26.3±11.1) kg(21.7-28.4 kg) respectively, and the difference was not statistically significant(P=0.074). Preoperative and postoperative ulnar variance were(-0.13±0.04) mm(-0.15--0.07 mm) and(-0.12±0.09) mm(-0.14--0.08 mm) respectively, and the difference was not statistically significant(P=0.081). No patient was in pain of elbow or wrist at pre-and post-operation. No heterotopic ossification was found at the osteotomy site in all patients. Conclusion Segmental osteotomy of the radial neck with the radial head preserved is easy to operate and effective for treatment of post-traumatic proximal radioulnar synostosis.

关 键 词：肘 关节强直 截骨术 桡骨 创伤和损伤 治疗结果 

分 类 号：R687.3[医药卫生—骨科学]