Song S H, Lee H, Youssef H, Oh S M, Park J H, Song H R
Institute for Rare Diseases Department of Orthopaedic Surgery, Korea University Medical Center, Guro Hospital, Seoul, Korea.
J Hand Surg Eur Vol. 2013 Mar;38(3):288-96. doi: 10.1177/1753193412450651. Epub 2012 Jun 19.
The aim of this study is to evaluate the results of gradual ulnar correction and lengthening using the modified Ilizarov technique for the treatment of forearm deformities in patients with multiple cartilaginous exostoses. We retrospectively reviewed 23 forearms in 16 patients. Three different types of operative procedures were performed: (1) corrective osteotomy and gradual lengthening of the ulna, (2) corrective osteotomy of the radius, and (3) excision of exostoses. We evaluated the radiographs; range of motion of the wrist, forearm, and elbow; and functional status using a questionnaire before and after operation. During the clinical interview, post-operative functional status was significantly improved than pre-operative functional status, 12 patients stated that they had no difficulty in performing daily activities, 11 patients stated that they had no pain, and 11 patients stated that the post-operative appearance of the operated forearm was satisfactory. At time of final follow-up, the mean range of motion of the wrist in ulnar/radial deviation, forearm pronation/supination was significantly improved. Also, the radiographic parameters including radial articular angle, carpal slip, radial bowing, and ulnar variance were significantly improved at time of final follow-up. In conclusion, we achieved successful clinical and radiological outcomes in our patients with forearm deformities after treatment with the modified Ilizarov method. However, there could be a recurrence of ulnar shortening and deformity during growth periods in skeletally immature patients.
本研究的目的是评估采用改良伊里扎洛夫技术进行尺骨逐步矫正和延长治疗多发性骨软骨瘤患者前臂畸形的效果。我们回顾性分析了16例患者的23条前臂。实施了三种不同类型的手术:(1)尺骨截骨矫正及逐步延长,(2)桡骨截骨矫正,(3)骨软骨瘤切除术。我们评估了术前和术后的X线片、腕关节、前臂和肘关节的活动范围以及使用问卷评估功能状态。在临床访谈中,术后功能状态较术前显著改善,12例患者表示日常活动无困难,11例患者表示无疼痛,11例患者表示手术前臂的术后外观令人满意。在末次随访时,腕关节尺偏/桡偏、前臂旋前/旋后的平均活动范围显著改善。此外,末次随访时包括桡骨关节角、腕骨滑移、桡骨弓形和尺骨差异在内的X线参数也显著改善。总之,采用改良伊里扎洛夫方法治疗后,我们的前臂畸形患者获得了成功的临床和影像学结果。然而,骨骼未成熟患者在生长期间可能会出现尺骨缩短和畸形复发。