Özkan Cenk, Deveci Mehmet Ali, Tekin Mustafa, Biçer Ömer Sunkar, Gökçe Kadir, Gülşen Mahir
Çukurova University, Faculty of Medicine, Department of Orthopedics and Traumatology, Adana, Turkey.
Çukurova University, Faculty of Medicine, Department of Orthopedics and Traumatology, Adana, Turkey.
Acta Orthop Traumatol Turc. 2017 Jan;51(1):29-33. doi: 10.1016/j.aott.2016.08.019. Epub 2016 Oct 17.
The present study assessed functional and radiographic outcomes of distraction osteogenesis treatment of post-traumatic elbow deformities in children.
Eight children were treated between 2008 and 2013 for post-traumatic elbow deformities using distraction osteogenesis. Mean age at time of operation was 10.9 years. Six patients had varus and 2 had valgus deformity. Magnitude of correction, fixator index, complications, carrying angle, and elbow range of motion were assessed. Functional results were graded according to protocol of Bellemore et al.
Mean follow-up was 43 months. Mean preoperative varus deformity in 6 patients was 29.2° and valgus deformity in 2 patients was 28.5°. Preoperative flexion and extension of elbow were 123.8° and -10.6°, respectively. Mean carrying angle was 9° valgus at last follow-up. Mean flexion and extension were 134.4° and -6.0°, respectively. Change in carrying angle was statistically significant (p = 0.002). There were 2 grade 1 pin tract infections and 1 diaphyseal fracture of humerus. Functional outcome was rated excellent in 7 patients and good in 1 patient.
Ilizarov distraction osteogenesis is a valuable alternative in treatment of elbow deformities in children. The surgical technique is simple and correction is adjustable. Gradual correction prevents possible neurovascular complications and minimally invasive surgery produces less scarring. Compliance of patient and family is key factor in the success of the outcome.
Level IV, therapeutic study.
本研究评估了儿童创伤后肘畸形牵张成骨治疗的功能和影像学结果。
2008年至2013年间，8名儿童因创伤后肘畸形接受牵张成骨治疗。手术时的平均年龄为10.9岁。6例为内翻畸形，2例为外翻畸形。评估了矫正程度、固定指数、并发症、提携角和肘关节活动范围。根据Bellemore等人的方案对功能结果进行分级。
平均随访43个月。6例患者术前平均内翻畸形为29.2°，2例患者术前外翻畸形为28.5°。术前肘关节屈伸分别为123.8°和-10.6°。末次随访时平均提携角为9°外翻。平均屈伸分别为134.4°和-6.0°。提携角的变化具有统计学意义（p = 0.002）。有2例1级针道感染和1例肱骨干骨折。7例患者功能结果评为优秀，1例评为良好。
伊里扎洛夫牵张成骨是治疗儿童肘畸形的一种有价值的替代方法。手术技术简单，矫正可调整。逐步矫正可预防可能的神经血管并发症，微创手术瘢痕少。患者及其家属的依从性是治疗成功的关键因素。
IV级，治疗性研究。
