Vorlat Peter, De Boeck Hugo
Department of Pediatric Orthopedics, University Hospital-VUB, Laarbeeklaan 101, B-1090 Brussels, Belgium.
Clin Orthop Relat Res. 2003 Aug(413):233-7. doi: 10.1097/01.blo.0000072901.36018.25.
Eleven children with forearm bowing fractures were followed up after 80 months. They were evaluated specifically for pain, function, and cosmesis. Remodeling was assessed by comparing radiographs. The mean age when the trauma occurred was 7 years 5 months. Forces longitudinal to the forearm axis are considered responsible for this injury. In six patients the deforming force was longitudinal, but in two other patients it might have been transversal. In three patients the mechanism of injury was unknown. The initial diagnosis was missed three times. Reduction was cumbersome in five of seven patients. In nine patients a residual curve was accepted. This resulted in a unique opportunity to evaluate the spontaneous remodeling. After 6 years of age, remodeling was less than generally accepted. From this it can be concluded that a transversal force is also capable of causing these injuries, that remodeling is less than generally accepted, and that reduction under general anesthesia should be considered in patients older than 6 years who have a cosmetically unacceptable bowing deformity that is greater than 10 degrees.
11名前臂弯曲骨折患儿在80个月后接受了随访。对他们进行了疼痛、功能和美观方面的专门评估。通过比较X线片评估重塑情况。受伤时的平均年龄为7岁5个月。与前臂轴线纵向的力被认为是造成这种损伤的原因。6名患者的致伤力是纵向的,但另外2名患者的致伤力可能是横向的。3名患者的受伤机制不明。最初的诊断有3次被漏诊。7名患者中有5名复位困难。9名患者接受了残留弯曲。这提供了一个评估自发重塑的独特机会。6岁以后,重塑情况比一般认为的要差。由此可以得出结论,横向力也能够导致这些损伤,重塑情况比一般认为的要差,对于6岁以上有大于10度的、在美观上不可接受的弯曲畸形的患者,应考虑在全身麻醉下进行复位。