Moon Myung-Sang, Kim Sung-Soo, Kim Seong-Tae, Lee Sung-Rak, Lee Bong-Jin, Jin Jong-Mun, Moon Jeong-Lim
Department of Orthopedic Surgery, Cheju Halla General Hospital, Jeju, Korea.
J Orthop Surg (Hong Kong). 2010 Aug;18(2):220-3. doi: 10.1177/230949901001800217.
To compare treatment outcomes after closing wedge osteotomy and plate fixation for cubitus varus deformity undertaken with or without medialisation of the distal fragment.
Records of 21 men and 16 women aged 20 to 34 years who underwent closing wedge osteotomy and plate fixation for cubitus varus deformity with (n=21) or without (n=16) medialisation of the distal fragment were reviewed. A daily alternate flexion-extension splinting was applied for one week for early restoration of full range of motion. The carrying angle and range of motion of the elbow were measured.
All patients regained the normal carrying angle and range of motion; none had loss of fixation or limitation in range of motion exceeding 10 degrees. Outcomes were excellent in 23 patients and good in 9. A small bony prominence over the lateral condylar region ('lazy S' deformity) was noted in group-1 but not group-2 patients.
Closing wedge supracondylar osteotomy with medialisation of the distal fragment was an effective treatment for cubitus varus deformity and minimised the risk of 'lazy S' deformity.
比较闭合楔形截骨联合钢板固定治疗肘内翻畸形时,远端骨折块进行或不进行内移的治疗效果。
回顾性分析21例男性和16例女性患者的记录,这些患者年龄在20至34岁之间,因肘内翻畸形接受了闭合楔形截骨联合钢板固定治疗,其中21例患者的远端骨折块进行了内移,16例未进行内移。术后每天交替进行屈伸夹板固定一周,以促进早期恢复全关节活动范围。测量了携带角和肘关节活动范围。
所有患者均恢复了正常的携带角和活动范围;无一例出现固定失败或活动范围受限超过10度的情况。23例患者疗效为优,9例为良。第1组患者在外侧髁区域出现了一个小的骨突起(“懒S”畸形),而第2组患者未出现。
闭合楔形髁上截骨联合远端骨折块内移是治疗肘内翻畸形的有效方法,并将“懒S”畸形的风险降至最低。