Swanson E, Boyd J B, Mulholland R S
Department of Surgery, Toronto General Hospital.
Plast Reconstr Surg. 1990 Feb;85(2):267-72.
An experimental study was undertaken to determine the effect of an osteotomy on radial strength and to compare two techniques used clinically to perform these osteotomies. Forty preserved human cadaveric radii were randomized into osteotomized (20) and nonosteotomized (20) groups. Osteotomized bones were further randomized into beveled-corner (10) and squared-corner (10) groups. A 9-cm-long, one-third thickness segment of bone was removed, similar to the defect resulting from a radial osteocutaneous transfer. All bones were tested to breaking using a four-point bending apparatus. Osteotomized radii were significantly weakened, with breaking strengths only 24 percent of the control group. Although the beveled osteotomy group appeared stronger than the squared osteotomy group, this finding was not significant with the numbers tested. In view of the weakness of the osteotomized radius, we recommend excising no more than one-third of the radial diameter and postoperative immobilization of the forearm for 8 weeks. A beveled osteotomy prevents overcutting at the corners and allows better visualization of the depth of cut. With these measures, the incidence of fracture may be reduced.
进行了一项实验研究，以确定截骨术对桡骨强度的影响，并比较临床上用于进行这些截骨术的两种技术。四十根保存的人体尸体桡骨被随机分为截骨组（20根）和非截骨组（20根）。截骨的骨头进一步随机分为斜角组（10根）和方角组（10根）。去除一段9厘米长、三分之一厚度的骨段，类似于桡骨骨皮瓣转移造成的缺损。所有骨头均使用四点弯曲装置测试至断裂。截骨后的桡骨明显变弱，断裂强度仅为对照组的24%。尽管斜角截骨组似乎比方角截骨组更强，但根据测试数量，这一发现并不显著。鉴于截骨后桡骨的脆弱性，我们建议切除的桡骨直径不超过三分之一，术后前臂固定8周。斜角截骨术可防止拐角处过度切割，并能更好地观察切割深度。采取这些措施，骨折发生率可能会降低。
