Kumar K, Sharma V K, Sharma R, Maffulli N
Aberdeen Royal Hospitals, Scotland.
J Trauma. 2000 Oct;49(4):717-21. doi: 10.1097/00005373-200010000-00021.
The purpose of this study was to compare the outcomes of two different techniques of supracondylar osteotomy, French osteotomy and dome osteotomy, for the correction of posttraumatic cubitus varus.
A comparative randomized study was undertaken of 25 patients (average age 10 years) with an established posttraumatic cubitus varus deformity (mean time from injury to corrective osteotomy, 1.7 years). Patients were followed-up with for 1 year, and carrying angle, Baumann's angle, and internal rotation deformity were measured. Postoperative complications were assessed.
A significant (p < 0.01) correction of carrying angle and Baumann's angle was achieved with both techniques, with no statistically significant differences between them. Although internal rotation deformity was corrected by both techniques, the correction was significantly greater with the dome osteotomy (p < 0.01). However, the persistence of internal rotation did not seem to affect the final outcome. There was a higher incidence of postoperative complications in the dome osteotomy group, including infection (1), inadequate correction (1), nerve palsy (1), loss of motion (5), and circulatory compromise (1).
The dome osteotomy is technically more difficult than the French osteotomy and has a higher incidence of complications. We suggest that the French osteotomy be used for the correction of cubitus varus after supracondylar fractures of the elbow in children.
本研究旨在比较两种不同的髁上截骨技术,即法国截骨术和圆顶截骨术,用于矫正创伤后肘内翻的效果。
对25例(平均年龄10岁)已确诊创伤后肘内翻畸形(受伤至矫正截骨的平均时间为1.7年)的患者进行了一项比较随机研究。对患者进行了1年的随访,测量了提携角、鲍曼角和内旋畸形。评估了术后并发症。
两种技术均实现了提携角和鲍曼角的显著(p < 0.01)矫正,两者之间无统计学显著差异。虽然两种技术均矫正了内旋畸形,但圆顶截骨术的矫正效果显著更好(p < 0.01)。然而,内旋的持续存在似乎并未影响最终结果。圆顶截骨术组术后并发症的发生率较高,包括感染(1例)、矫正不足(1例)、神经麻痹(1例)、活动丧失(5例)和循环障碍(1例)。
圆顶截骨术在技术上比法国截骨术更困难,并发症发生率更高。我们建议在儿童肘部髁上骨折后使用法国截骨术矫正肘内翻。