Department of Orthopaedic Surgery, Erasmus Medical Center, Westzeedijk 361, Postbus 2040, 3000 CA, Rotterdam, The Netherlands,
Arch Orthop Trauma Surg. 2014 Mar;134(3):333-41. doi: 10.1007/s00402-014-1922-y. Epub 2014 Jan 30.
Although both-bone forearm fractures in children may result in severe limitation of forearm rotation, finding the cause remains a diagnostic challenge. This study tries to evaluate the role of rotational malunion, bony impingement and contractures of the interosseous membrane.
Children (5-16 years) who suffered from a both-bone forearm fracture in diaphysis or distal metaphysis with a limitation of pronation/supination ≥40° at ≥6 months after trauma were included for analysis with conventional radiographs, computed tomography (CT) and magnetic resonance imaging (MRI).
A total of 410 children with a both-bone forearm fracture were prospectively followed in four Dutch hospitals. At a median of 205 days, 7.3 % suffered from a limitation of pronation/supination ≥40°. 14 children were included (median limitation of 40°) and the radiographs revealed a median maximum angular malunion of 16°. CT analysis showed rotational malunion of both radius (median 19°) and ulna (median 9°). MRI analysis revealed neither bony impingement nor contractures of the interosseous membrane.
Three-dimensional imaging of children with a severe limitation of pronation/supination after a both-bone forearm fracture revealed rotational malunions of both radius and ulna without bony impingement or soft tissue contractures.
Prospective multicenter study, Level 2.
儿童双骨干前臂骨折可导致严重的前臂旋转受限，但寻找病因仍然具有挑战性。本研究旨在评估旋转对线不良、骨撞击和骨间膜挛缩的作用。
本研究纳入了在创伤后 6 个月以上存在旋前/旋后受限≥40°的儿童（5-16 岁），这些儿童存在骨干或干骺端双骨干前臂骨折，并进行常规 X 线、计算机断层扫描（CT）和磁共振成像（MRI）检查。
在四个荷兰医院前瞻性随访了 410 例双骨干前臂骨折患儿。在中位数为 205 天的时间里，7.3%的患儿存在旋前/旋后受限≥40°。纳入了 14 例患儿（中位数受限 40°），X 线显示最大角度对线不良的中位数为 16°。CT 分析显示桡骨（中位数 19°）和尺骨（中位数 9°）均存在旋转对线不良。MRI 分析未发现骨撞击或骨间膜挛缩。
三维成像显示，严重旋前/旋后受限的儿童双骨干前臂骨折存在桡骨和尺骨的旋转对线不良，但无骨撞击或软组织挛缩。
前瞻性多中心研究，2 级。
