Rolfe Kevin W, Green Terri A, Lawrence John F
Kaiser Oakland Medical Center, Oakland, CA, USA.
J Pediatr Orthop. 2009 Jun;29(4):406-10. doi: 10.1097/BPO.0b013e3181a6bf90.
The purpose of this study was to present the authors' experience with corrective osteotomies of the forearm for supination contracture in children.
Fourteen patients with supination contracture of the forearm due to brachial plexus lesion (11), poliomyelitis residuals (2), or Monteggia fracture malunion (1) underwent distal ulnar osteotomy without fixation and subsequent midradial osteotomy with plate fixation to produce a position of greater pronation. A minimum of 6 months' follow-up was required to be included in the series.
Ten boys and 4 girls whose mean age was 11 years underwent surgery between 1998 and 2006 to correct a supination contracture. The mean preoperative contracture measured 80 degrees of supination. The final mean postoperative correction was 104 degrees, whereas the final mean position of pronation was 24 degrees.
Distal ulnar and midradial osteotomies are effective in the treatment of supination deformities of the forearm with little risk of complication or need for additional surgery. Radial fixation is important, but ulnar fixation is not required. Both osteotomies must be complete before plate fixation of the radius to realize maximal correction.
Level IV.
本研究旨在介绍作者对儿童前臂旋后挛缩进行截骨矫正术的经验。
14例因臂丛神经损伤（11例）、小儿麻痹后遗症（2例）或孟氏骨折畸形愈合（1例）导致前臂旋后挛缩的患者，接受了尺骨远端截骨不固定及随后的桡骨中段截骨钢板固定，以获得更大的旋前位。该系列研究要求至少随访6个月。
1998年至2006年间，10名男孩和4名女孩（平均年龄11岁）接受了手术以矫正旋后挛缩。术前平均挛缩度数为旋后80度。术后最终平均矫正度数为104度，而最终平均旋前位为24度。
尺骨远端和桡骨中段截骨术治疗前臂旋后畸形有效，并发症风险小，无需额外手术。桡骨固定很重要，但尺骨无需固定。在桡骨钢板固定前，两处截骨都必须完成，以实现最大程度的矫正。
四级。
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