Hung Nguyen Ngoc
Vietnam National Hospital of Pediatrics, 18/879 La Thanh Road, Dong Da District, Hanoi, Vietnam,
J Child Orthop. 2008 Dec;2(6):481-9. doi: 10.1007/s11832-008-0146-5. Epub 2008 Nov 18.
To evaluate the clinical and functional results of a technical procedure in the surgical treatment of congenital radioulnar synostosis in children.
A prospective study had been undertaken from January 1992 to December 2004. Thirty-four patients with congenital radioulnar synostosis that are fixed in pronation were recruited. Congenital radioulnar synostosis was classified for two types according to Tachdjian's criteria. All patients were treated by resection of the proximal radius and the distal ulna to remove a segmental bone of both parts of the forearm. After K-wires are inserted intramedullarly into both bones, the forearm is derotated manually, followed by cast immobilization.
There were 34 patients (52 forearms) with congenital radioulnar synostosis, whom the average age at surgery was 6 years and 3 months. There were two types of congenital radioulnar synostosis: Type 1 in six forearms (11.6%) and Type 2 in 46 forearms (88.4%). The preoperative forearm rotation ranged from 65 degrees to 85 degrees pronation. The postoperative forearm rotation angle was corrected from 0 degrees to 30 degrees ; the best end position appears to be 70-100% of pronation. Of the patients, 78.8% had good or excellent results. All patients were operated on without complications; five patients had loss of correction during cast immobilization. Overall, the patient's ability to perform daily activities showed a marked improvement after surgery.
This method is a simple and safe technique to derotate the forearms of patients with congenital radioulnar synostosis that are fixed in pronation.
评估一种技术程序在儿童先天性桡尺骨融合手术治疗中的临床和功能效果。
1992年1月至2004年12月进行了一项前瞻性研究。招募了34例固定于旋前位的先天性桡尺骨融合患者。根据塔奇吉安标准，先天性桡尺骨融合分为两种类型。所有患者均接受近端桡骨和远端尺骨切除，以去除前臂两部分的一段骨头。在两根骨头内髓内插入克氏针后，手动旋转前臂，随后进行石膏固定。
有34例（52侧前臂）先天性桡尺骨融合患者，手术时平均年龄为6岁3个月。先天性桡尺骨融合有两种类型：1型6侧前臂（11.6%），2型46侧前臂（88.4%）。术前前臂旋转范围为旋前65度至85度。术后前臂旋转角度从0度矫正至30度；最佳最终位置似乎是旋前的70 - 100%。78.8%的患者结果为良好或优秀。所有患者手术均无并发症；5例患者在石膏固定期间矫正丢失。总体而言，患者术后日常生活活动能力有显著改善。
该方法是一种简单安全的技术，可用于矫正固定于旋前位的先天性桡尺骨融合患者的前臂。
