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采用肱三头肌旁入路(保留肱三头肌)行穹窿截骨术治疗儿童肘内翻畸形:一种避免外侧髁突出的手术技术

Dome osteotomy using the paratricipital (triceps-sparing) approach for cubitus varus deformity in children: a surgical technique to avoid lateral condylar prominence.

作者信息

Ali Ayman M, Abouelnas Bassam A, Elgohary Hatem S A

机构信息

Department of Orthopedic Surgery, Mansoura University, Mansoura, Egypt.

出版信息

J Pediatr Orthop B. 2016 Jan;25(1):62-8. doi: 10.1097/BPB.0000000000000205.

Abstract

Twenty patients (11 males and nine females) with cubitus varus deformity were treated with corrective dome osteotomy through the paratricipital approach. Patients presented after an average 3 years of appearance of the deformity. The average age of the patients was 8.5 years (range 6-14 years). All patients had a previous history of supracondylar fracture. Preoperatively, carrying angle, lateral condylar prominent index, and range of motion were recorded. There were no intraoperative complications. Postoperatively, three patients developed a superficial skin infection. No patient had unsightly scarring or a prominent lateral condyle. No patient reported pain, motor weakness, or atrophy of the arm musculature. There was no fixation failure or loss of correction during the healing stage and no revision surgery was needed. The results were graded according to the preoperative and postoperative carrying angle, movement of flexion and extension, and lateral condylar prominence index and they were evaluated statistically. Preoperative and postoperative extension, carrying angle, and lateral condylar prominence index were statistically significant. Corrective dome osteotomy using the paratricipital approach seems to be a reliable technique for correction of cubitus varus in children. The procedure is relatively simple and enables correction of the deformity without inducing lateral condylar prominence.

摘要

20例肘内翻畸形患者(11例男性,9例女性)采用经肱三头肌旁入路的矫正性圆顶截骨术进行治疗。患者在畸形出现平均3年后前来就诊。患者的平均年龄为8.5岁(范围6 - 14岁)。所有患者既往均有髁上骨折病史。术前记录提携角、外侧髁突出指数和活动范围。术中无并发症发生。术后,3例患者出现浅表皮肤感染。无患者出现瘢痕难看或外侧髁突出的情况。无患者报告手臂疼痛、肌无力或肌肉萎缩。愈合阶段无内固定失败或矫正丢失情况,无需翻修手术。根据术前和术后的提携角、屈伸活动度以及外侧髁突出指数对结果进行分级,并进行统计学评估。术前和术后的伸展、提携角以及外侧髁突出指数具有统计学意义。采用经肱三头肌旁入路的矫正性圆顶截骨术似乎是矫正儿童肘内翻的一种可靠技术。该手术相对简单,能够矫正畸形而不引起外侧髁突出。

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