Sonderegger J, Gidwani S, Ross M
Spital Grabs, Departement Chirurgie und Orthopädie, Grabs, Switzerland.
J Hand Surg Eur Vol. 2012 Mar;37(3):244-50. doi: 10.1177/1753193411421094. Epub 2011 Oct 10.
The surgical treatment of post-traumatic radioulnar synostosis is difficult. Recurrence after resection alone is a concern with poor long-term maintenance of forearm rotation. We report on the use of pedicled adipofascial flaps to prevent recurrence and facilitate maintenance of movement in six adult patients with radioulnar synostosis. Five involved the proximal radioulnar joint and one the distal radioulnar joint. In four the flap was based on the radial artery and in two on the posterior interosseous artery. Mean intraoperative supination was 78° and pronation was 76°. Mean follow up was 32 months. At follow-up, mean supination was 71° and pronation was 70°. No patient had radiological recurrence of synostosis. The only complication was a transient posterior interosseous nerve palsy. Pedicled adipofascial flaps are a safe addition to resection alone which may prevent recurrence and maintain the range of forearm rotation achieved at operation.
创伤后桡尺骨融合的手术治疗具有挑战性。单纯切除术后复发是一个问题，前臂旋转的长期维持效果不佳。我们报告了使用带蒂脂肪筋膜瓣预防复发并促进6例桡尺骨融合成年患者运动维持的情况。5例累及近端桡尺关节，1例累及远端桡尺关节。4例皮瓣以桡动脉为蒂，2例以后骨间动脉为蒂。术中平均旋前为78°，旋后为76°。平均随访32个月。随访时，平均旋前为71°，旋后为70°。没有患者出现融合的影像学复发。唯一的并发症是短暂性骨间后神经麻痹。带蒂脂肪筋膜瓣是单纯切除术的一种安全补充，可预防复发并维持手术时获得的前臂旋转范围。
