Bätz W, Hofmann-v Kap-herr S, Pistor G
Aktuelle Traumatol. 1986 Feb;16(1):13-6.
This article reports on five children treated surgically during 1973-1975 for posttraumatic radioulnar synostosis. The synostoses had developed as a complication after a proximal radial fracture. Lesion of the proximal ulna plays an important part in creating such an osseous union. Another factor of equal importance is the traumatization of the tissues during surgical treatment of the fracture, especially if debris of the periosteum and fine bone fragments additionally enter into the space between radius and ulna. Formation of excess callus, and hence synostosis, is also promoted if repositioning or re-repositioning of a proximal radial fracture is effected too late. The article presents the technique of surgical treatment of proximal radioulnar synostosis with Lyodura sheathing. Follow-up examination of the five children during an observation period of five years showed good results in two children, a moderate result in one, and poor results of surgery in two cases. Improved results may be expected from further improvement of the surgical method, such as resection of the bicipital tuberosity (tuberositas radii) or from additional partial sheathing of the ulna at the side facing the radius.
本文报道了1973年至1975年间接受手术治疗的5例创伤后桡尺骨融合患儿。这些融合是桡骨近端骨折后的并发症。尺骨近端损伤在形成这种骨性连接中起重要作用。另一个同等重要的因素是骨折手术治疗期间组织的创伤，特别是如果骨膜碎片和细小骨碎片额外进入桡骨和尺骨之间的间隙。如果桡骨近端骨折的复位或再次复位过晚，也会促进过多骨痂形成，进而导致融合。本文介绍了用Lyodura鞘膜进行桡尺骨近端融合手术治疗的技术。对这5例患儿进行了为期5年的随访检查，结果显示2例效果良好，1例效果中等，2例手术效果不佳。通过进一步改进手术方法，如切除二头肌结节（桡骨粗隆）或在尺骨面向桡骨的一侧额外进行部分鞘膜覆盖，有望取得更好的效果。
