Wang Enbo, Wenger Dennis R, Zhang Lijun, Zhao Qun, Ji Shijun, Li Jianjun
Shengjing Hospital, China Medical University, Shenyang, China.
J Pediatr Orthop. 2010 Apr-May;30(3):277-81. doi: 10.1097/BPO.0b013e3181d48394.
We have evaluated and treated 3 cases of acute onset elbow flexion contracture in children ranging in age from 6 to 13 years, with type-IV (Cleary and Omer) congenital proximal radioulnar synostosis. All were resolved by manipulative traction under general anesthesia during which an audible elbow "snap" was noted. Two of the cases required surgical treatment of a deformed radial head with good results after a 2 to 4-year follow-up. Our clinical radiographic and intraoperative evidence suggests that the acute onset fixed-flexion contracture results from an anterosuperiorly overgrown dislocated radial head becoming trapped under hypertrophied annular ligament-type tissue after elbow hyperflexion. Excision of the dislocated radial head after release from its entrapment was effective in 2 of the 3 patients in this report, and should be considered.
我们评估并治疗了3例年龄在6至13岁之间、患有IV型（克利里和奥默分型）先天性近端桡尺关节融合的儿童急性发作性肘关节屈曲挛缩病例。所有病例均在全身麻醉下通过手法牵引得到解决，在此过程中可听到肘部“啪”的一声。其中2例因桡骨头畸形需要手术治疗，经过2至4年的随访，效果良好。我们的临床影像学和术中证据表明，急性发作的固定性屈曲挛缩是由于过度生长并向前上方脱位的桡骨头在肘关节过度屈曲后被困在肥厚的环状韧带样组织下方所致。在本报告的3例患者中，有2例在解除脱位桡骨头的卡压后将其切除有效，应予以考虑。
