Osterman A Lee, Arief Melissa S
Department of Orthopaedic & Hand Surgery, Philadelphia Hand to Shoulder Center, Thomas Jefferson University, Philadelphia, PA.
KSF Orthopaedic Center, Houston, TX, USA,
Orthop Res Rev. 2017 Dec 5;9:101-106. doi: 10.2147/ORR.S109483. eCollection 2017.
Post-traumatic radioulnar synostosis is a rare complication after forearm or elbow injury that can result in loss of motion and significant disability. Risk factors include aspects of the initial trauma and of the surgical treatment of that trauma. Surgical intervention for synostosis is the standard of care and is determined based on the location of the bony bridge. Surgical timing is recommended between 6 months and 2 years with recent advocacy for the 6- to 12-month period after radiographs demonstrate bony maturation but early enough to prevent further stiffness and contractures. For most types of synostosis, surgical resection with interposition graft is recommended. The types of materials used include synthetic, allograft, and vascularized and non-vascularized materials, but currently there is no consensus on which is the most preferable. Adjuvant therapy is not considered necessary for all cases but can be beneficial in patients with high risk factors such as recurrence or traumatic brain injury. Postoperative rehabilitation should be performed early to maintain range of motion.
创伤后桡尺骨融合是前臂或肘部损伤后一种罕见的并发症，可导致活动丧失和严重残疾。危险因素包括初始创伤及该创伤手术治疗的各方面因素。融合的手术干预是标准治疗方法，其根据骨桥的位置来确定。建议手术时机在6个月至2年之间，近期主张在X线片显示骨成熟后的6至12个月期间进行手术，但要足够早以防止进一步僵硬和挛缩。对于大多数类型的融合，建议采用带植入物的手术切除。使用的材料类型包括合成材料、同种异体移植物以及带血管和不带血管的材料，但目前对于哪种材料最适宜尚无共识。并非所有病例都认为需要辅助治疗，但对于有复发或创伤性脑损伤等高危险因素的患者可能有益。术后应尽早进行康复以维持活动范围。
