Charles Y-P, Diméglio A, Chammas M
Service d'orthopédie pédiatrique, hôpital Lapeyronie, CHU de Montpellier, 371 avenue du Doyen-Gaston-Giraud, Montpellier cedex 05, France.
Chir Main. 2009 Feb;28(1):26-32. doi: 10.1016/j.main.2008.11.003. Epub 2008 Nov 25.
Congenital pseudarthrosis of the forearm represents a rare entity which is often associated with neurofibromatosis type I. Isolated pseudarthrosis of the ulna is the most frequent deformity, followed by pseudarthrosis of the radius and both forearm bones. The treatment of these deformities remains difficult: conventional bone grafts rarely lead to complete fusion. The reconstruction by a vascularized fibular graft represents the treatment of choice if the radial head is not dislocated. This procedure allows restoration of a balance between radius and ulna during growth. The presence of a vascularized graft enhances the potential for bony fusion in a fibrous environment. In cases of isolated ulna pseudarthrosis, a luxation of the proximal radial epiphysis may occur when the ulnar deformity increases with time. The single-bone forearm represents a salvage procedure that creates a stable upper limb with a satisfactory wrist and elbow function. The two clinical cases of a pseudarthrosis of both forearm bones and of an ulna pseudarthrosis are presented.
先天性前臂假关节是一种罕见的病症,常与Ⅰ型神经纤维瘤病相关。孤立性尺骨假关节是最常见的畸形,其次是桡骨假关节和双侧前臂骨假关节。这些畸形的治疗仍然很困难:传统的骨移植很少能实现完全融合。如果桡骨头没有脱位,带血管蒂腓骨移植重建是首选的治疗方法。该手术可在生长过程中恢复桡骨和尺骨之间的平衡。带血管蒂移植物的存在增加了在纤维环境中实现骨融合的可能性。在孤立性尺骨假关节的病例中,随着尺骨畸形随时间加重,可能会出现桡骨近端骨骺脱位。单骨前臂是一种补救手术,可创建一个具有满意腕关节和肘关节功能的稳定上肢。本文介绍了双侧前臂骨假关节和尺骨假关节的两个临床病例。