Manske P R
Clin Orthop Relat Res. 1979 Mar-Apr(139):125-7.
A 3 1/2-year-old white girl with neurofibromatosis sustained left radius and ulna fractures. The radius was sclerotic with no medullary canal at the fracture site, and the ulna was hypoplastic distal to the fracture. The fractures failed to unite when immobilized in a long arm plaster cast for 5 months and pseudarthrosis developed. Three subsequent operative attempts to obtain union of the pseudarthrosis by means of internal fixation and bone grafting over the next 30 months were also unsuccessful, and the pseudarthrosis persisted. The forearm was supported in a custom molded leather brace until the child was 13 1/2 years old and had reached skeletal maturity. Osseous union was then operatively obtained using dual onlay tibial cortical and cancellous bone grafts. There has been no recurrence of the pseudarthrosis 3 years and 2 months after bone grafting. The author recommends postponing surgical attempts to achieve union of the forearm bone pseudarthrosis associated with neurofibromatosis until the patient reaches skeletal maturity.
一名3岁半患有神经纤维瘤病的白人女孩发生了左桡骨和尺骨骨折。骨折部位的桡骨硬化，髓腔消失，尺骨在骨折远端发育不全。骨折部位用长臂石膏固定5个月后未愈合，形成了假关节。在接下来的30个月里，又进行了三次手术尝试，通过内固定和植骨来促使假关节愈合，但均未成功，假关节依然存在。前臂一直用定制的皮革支具支撑，直到孩子13岁半骨骼成熟。随后通过使用双侧贴附式胫骨皮质骨和松质骨移植手术实现了骨愈合。骨移植3年零2个月后，假关节未再复发。作者建议，对于与神经纤维瘤病相关的前臂骨假关节，手术尝试应推迟到患者骨骼成熟后进行。
