Prabhu Jagadish, Faqi Mohammed K, Al Khalifa Fahad, Awad Rashad K
Department of Orthopedics, Bahrain Defence Force Hospital - Royal Medical Services, Kingdom of Bahrain.
Open Orthop J. 2017 Mar 31;11:263-267. doi: 10.2174/1874325001711010263. eCollection 2017.
Various types of osteotomies have been used to facilitate reduction of the radial head and to prevent recurrent subluxation. The Bouyala technique - open reduction of radial head associated with open wedge ulnar osteotomy with or without annular ligament reconstruction, is presently the most widely used treatment for long- standing traumatic dislocation of the radial head, independently of age, in the absence of osteoarthritis remodeling, and should preferably be performed within 1 year of trauma.
In this article, we present a similar case operated by same technique, but we used synthetic phosphocalcic ceramic wedge graft instead of auto bone graft as described in many other studies. We believe that, this will limit the donor site morbidity and also aid in achieving better stability at osteotomy site, which in turn help in proceeding with early active mobilization protocol.
We achieved union of the osteotomy by three months. Clinically, there was no deformity and she achieved full pain-free range of motion of elbow joint.
We believe that, use of synthetic phosphocalcic ceramic wedge graft allow rigid fixation of osteotomy, provides additional stability, decrease the risk of secondary displacement and allow early mobilization, which may minimize contracture and we could achieve fairly good clinical outcome.
已采用多种类型的截骨术来促进桡骨头复位并防止反复半脱位。布亚拉技术——桡骨头切开复位联合开放楔形尺骨截骨术，无论有无环状韧带重建，目前是治疗桡骨头长期创伤性脱位最广泛使用的方法，适用于无骨关节炎重塑的任何年龄患者，且最好在创伤后1年内进行。
在本文中，我们展示了1例采用相同技术进行手术的类似病例，但我们使用了合成磷酸钙陶瓷楔形移植物，而不是许多其他研究中所述的自体骨移植。我们认为，这将限制供区并发症，并且有助于在截骨部位实现更好的稳定性，进而有助于实施早期主动活动方案。
我们在3个月时实现了截骨愈合。临床上，没有畸形，患者肘关节实现了完全无痛的活动范围。
我们认为，使用合成磷酸钙陶瓷楔形移植物可实现截骨的坚强固定，提供额外稳定性，降低二次移位风险并允许早期活动，这可能使挛缩最小化，并且我们可以取得相当好的临床效果。
