Buß Fokko Richard, Schulz Arndt-Peter, Lill Helmut, Voigt Christine
Friederikenstift Hospital Hannover, Department of Trauma and Reconstructive Surgery, Humboldtstraße 5, D-30169 Hannover, Germany.
Open Orthop J. 2011;5:389-94. doi: 10.2174/1874325001105010389. Epub 2011 Dec 30.
Cubitus varus deformity is the most common late complication after distal humeral fractures in children. Typical symptoms are increasing instability especially the posterolateral rotatory instability (POLRI), lateral elbow pain and cosmetic problems. Different ways of correction have been described but a gold standard has not yet been established.
In this study the clinical outcome 6,5 months after supracondylar closed wedge osteotomy stabilized with locking plates in four young adults was investigated: three with a posttraumatic varus deformity and one with a posttraumatic valgus deformity of the distal humerus.
All patients showed good or excellent results in the Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand score (DASH). In one case, a revision because of a delayed union was necessary, in another case a preexisting pseudarthrosis of the radial epicondyle remained. Neither a residual instability of the elbow joint, nor any significant prominence of the lateral epicondyle was observed.
The supracondylar closed wedge osteotomy stabilized by a locking plate is an effective procedure for the correction of posttraumatic distal humerus deformities in young adults with good final functional results.
肘内翻畸形是儿童肱骨远端骨折最常见的晚期并发症。典型症状是稳定性增加，尤其是后外侧旋转不稳定（POLRI）、外侧肘部疼痛和外观问题。已经描述了不同的矫正方法，但尚未确立金标准。
本研究调查了4名年轻成人采用锁定钢板固定的髁上闭合楔形截骨术后6.5个月的临床结果：3例创伤后肘内翻畸形，1例创伤后肱骨远端外翻畸形。
所有患者在梅奥肘关节功能评分（MEPS）和上肢、肩部和手部功能障碍评分（DASH）中均显示出良好或优异的结果。1例因骨不连需要翻修，另1例桡骨小头原有假关节仍然存在。未观察到肘关节残留不稳定，也未观察到外侧髁明显突出。
锁定钢板固定的髁上闭合楔形截骨术是矫正年轻成人创伤后肱骨远端畸形的有效方法，最终功能结果良好。
