Claessen Femke M A P, Louwerens Jan K G, Doornberg Job N, van Dijk C Niek, van den Bekerom Michel P J, Eygendaal Denise
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School and University of Amsterdam Medical School, Boston, MA, USA,
J Child Orthop. 2015 Feb;9(1):1-8. doi: 10.1007/s11832-014-0630-z. Epub 2015 Jan 11.
A systematic review regarding clinical studies on Hegemann's disease and fishtail deformity was performed with the aims to: (1) formulate the most up-to-date theory on aetiology in order to better define these conditions, (2) summarise the most frequent radiographic descriptions on radiographs and (3) give an overview of different treatment options.
A systematic review of studies to date on Hegemann's disease and fishtail deformity was performed. Studies were eligible if: (1) the article provides a description of Hegemann's disease or fishtail deformity, (2) original data of at least one patient was available, (3) the article was written in English, German or Dutch and (4) a full manuscript was available. Animal studies, reviews and expert opinions were not included.
We included a total of 22 articles: seven regarding Hegemann's disease including eight patients and 15 regarding fishtail deformity including 58 patients.
Fishtail deformity and Hegemann's disease seem to be a spectrum of vascular disorders of the distal humerus, varying from a benign mild vascular disorder to a complete avascular necrosis after fractures. Additional imaging is advised to confirm the presence of a fishtail deformity, intra-articular loose bodies and signs of osteoarthritis to decide if, and what, operative treatment is needed. As long as no clear aetiology for both diseases exist and the clinical symptoms and radiographic appearance are difficult to distinguish, both entities should preferably be named as 'vascular disturbance of the trochlear growth plate' to overcome confusing definitions and discussions.
对有关黑格曼病和鱼尾状畸形的临床研究进行系统评价，旨在：（1）制定最新的病因学理论，以便更好地界定这些病症；（2）总结X线片上最常见的影像学描述；（3）概述不同的治疗选择。
对迄今为止有关黑格曼病和鱼尾状畸形的研究进行系统评价。符合以下条件的研究纳入评价：（1）文章对黑格曼病或鱼尾状畸形进行了描述；（2）有至少一名患者的原始数据；（3）文章以英文、德文或荷兰文撰写；（4）有完整的手稿。动物研究、综述和专家意见不纳入。
共纳入22篇文章：7篇关于黑格曼病，涉及8例患者；15篇关于鱼尾状畸形，涉及58例患者。
鱼尾状畸形和黑格曼病似乎是肱骨远端血管疾病的一个谱系，从良性轻度血管疾病到骨折后完全性缺血性坏死不等。建议进行额外的影像学检查，以确认鱼尾状畸形、关节内游离体和骨关节炎体征的存在，从而决定是否需要手术治疗以及采取何种手术治疗。只要这两种疾病的病因尚不明确，且临床症状和影像学表现难以区分，最好将这两种情况都命名为“滑车生长板血管紊乱”，以避免定义混淆和讨论混乱。
