Huang Hui-Kuang, Hsu Shiuan-Hau, Hsieh Feng-Chi, Chang Kai-Hui, Chu Heuy-Ling, Wang Jung-Pan
Department of Surgery, School of Medicine, National Yang-Ming University.
Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei.
Tech Hand Up Extrem Surg. 2019 Dec;23(4):186-190. doi: 10.1097/BTH.0000000000000252.
Surgical correction of the distal radius fracture malunion is challenging because of the 3-dimensional deformity. We propose a method by using the Kapandji intrafocal pinning in corrective osteotomy for treatment of the distal radius fracture malunion to facilitate the alignment correction while using the bone graft to restore the radial length. The surgery was started with the osteotomy from a volar approach, and the osteotomy gap was expanded gradually. Then, allobone grafting was performed to maintain the corrected radial length. We used the Kapandji intrafocal pinning dorsally to provide dorsal supporting force and radially to correct the radial inclination. Finally, a volar plate was used to buttress and push the distal fragment to fit as to regain the correct volar tilt. We enrolled 10 patients of distal radius fracture malunion with a mean age of 59.3 years. All patients had bone healing within 3 months after surgery. The mean lengthened distance was 5 mm. The radial inclination and volar tilt could be corrected with improved functional results.
由于存在三维畸形，桡骨远端骨折畸形愈合的手术矫正具有挑战性。我们提出一种在矫正截骨术中使用卡潘迪病灶内穿针的方法来治疗桡骨远端骨折畸形愈合，在使用植骨恢复桡骨长度的同时便于对线矫正。手术从掌侧入路进行截骨开始，逐渐扩大截骨间隙。然后，进行异体骨移植以维持矫正后的桡骨长度。我们在背侧使用卡潘迪病灶内穿针以提供背侧支撑力，并在桡侧矫正桡骨倾斜度。最后，使用掌侧钢板支撑并推动远端骨折块以使其贴合，从而恢复正确的掌侧倾斜。我们纳入了10例桡骨远端骨折畸形愈合患者，平均年龄为59.3岁。所有患者术后3个月内均实现骨愈合。平均延长距离为5毫米。桡骨倾斜度和掌侧倾斜度得以矫正，功能结果得到改善。
