Suzuki T, Seki A, Nakamura T, Ikegami H, Takayama S, Nakamura M, Matsumoto M, Sato K
Keio University School of Medicine, 35 Shinano-machi, Shinjuku, Tokyo 160-8582, Japan.
National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo 157-0074, Japan.
Bone Joint J. 2015 Nov;97-B(11):1582-7. doi: 10.1302/0301-620X.97B11.36009.
This retrospective study was designed to evaluate the outcomes of re-dislocation of the radial head after corrective osteotomy for chronic dislocation. A total of 12 children with a mean age of 11 years (5 to 16), with further dislocation of the radial head after corrective osteotomy of the forearm, were followed for a mean of five years (2 to 10). Re-operations were performed for radial head re-dislocation in six children, while the other six did not undergo re-operation ('non-re-operation group'). The active range of movement (ROM) of their elbows was evaluated before and after the first operation, and at the most recent follow-up. In the re-operation group, there were significant decreases in extension, pronation, and supination when comparing the ROM following the corrective osteotomy and following re-operation (p < 0.05). The children who had not undergone re-operation achieved a better ROM than those who had undergone re-operation. There was a significant difference in mean pronation (76° vs 0°) between the non- re-operation and the re-operation group (p = 0.002), and a trend towards increases in mean flexion (133° vs 111°), extension (0° vs 23°), and supination (62° vs 29°). We did not find a clear benefit for re-operation in children with a re-dislocation following corrective osteotomy for chronic dislocation of the radial head.
本回顾性研究旨在评估慢性桡骨头脱位矫正截骨术后桡骨头再脱位的结局。共有12例平均年龄11岁(5至16岁)的儿童,在前臂矫正截骨术后出现桡骨头进一步脱位,平均随访5年(2至10年)。6例儿童因桡骨头再脱位接受了再次手术,另外6例未接受再次手术(“非再次手术组”)。在首次手术前后以及最近一次随访时评估其肘关节的主动活动范围(ROM)。在再次手术组中,比较矫正截骨术后和再次手术后的ROM时,伸展、旋前和旋后均有显著下降(p<0.05)。未接受再次手术的儿童比接受再次手术的儿童获得了更好的ROM。非再次手术组和再次手术组之间的平均旋前角度存在显著差异(76°对0°,p = 0.002),并且平均屈曲(133°对111°)、伸展(0°对23°)和旋后(62°对29°)有增加的趋势。对于慢性桡骨头脱位矫正截骨术后再脱位的儿童,我们未发现再次手术有明显益处。