Mader Konrad, Koolen Marianne, Flipsen Mark, van der Zwan Arnard, Pennig Dietmar, Ham John
Orthopædic Department, Section Upper Extremity, Asklepios Hamburg Altona, Paul-Ehrlich-Straße 1, 22763 Hamburg, Germany.
Department of Surgical Sciences (K1), University in Bergen, Bergen, Norway.
Obere Extrem. 2015;10(4):229-239. doi: 10.1007/s11678-015-0341-1. Epub 2015 Oct 14.
Complex posttraumatic forearm deformities have a significant impact on the integrity of the upper extremity leading to pain, instability in both the proximal and/or distal radioulnar articulation, and reduced range of forearm motion. Corrective osteotomy or more advanced procedures for malunited fractures or other posttraumatic deformities of the upper extremity, especially in the forearm are challenging procedures. In this review we will discuss the essential aspects of anatomy and pathomechanics, clinical and radiological assessment and the pathway from preoperative planning to the actual deformity correction surgery, either with one-stage correction or using gradual lengthening with external fixation ("callotasis techniques") and finally the functional outcome we can expect for our patients. In addition we will analyze the modern computer-assisted techniques available to date.
复杂的创伤后前臂畸形对上肢的完整性有重大影响,会导致疼痛、近端和/或远端桡尺关节不稳定以及前臂活动范围减小。对于上肢尤其是前臂的骨折不愈合或其他创伤后畸形进行矫正截骨术或更先进的手术是具有挑战性的操作。在本综述中,我们将讨论解剖学和病理力学的基本方面、临床和放射学评估,以及从术前规划到实际畸形矫正手术的过程,包括一期矫正或使用外固定架逐渐延长(“骨痂延长技术”),最后讨论我们对患者所能期望的功能结果。此外,我们还将分析目前可用的现代计算机辅助技术。