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采用自体骨移植和 Hoffmann II 型外固定治疗肱骨髁上骨不连。

Treatment of supracondylar humeral non-union by bone autograft and Hoffmann II external fixation.

作者信息

Pierreux Pieter Antoine, Moungondo Fabian, Schuind Frédéric Arthur

机构信息

Erasme University Hospital Brussels, 808, route de Lennik Brussels, 1070 Brabant, Belgium.

Erasme University Hospital Brussels, 808, route de Lennik Brussels, 1070 Brabant, Belgium.

出版信息

Orthop Traumatol Surg Res. 2020 Apr;106(2):371-376. doi: 10.1016/j.otsr.2019.11.014. Epub 2020 Jan 24.

Abstract

Supracondylar humeral nonunions are difficult to heal by internal fixation. Prosthetic arthroplasty is a solution in elderly patients. Both therapeutic options are contraindicated in the case of an infection. The article reports bone autografting and Hoffmann humero-humeral and temporary humero-ulnar Hoffmann external fixation. In our series of seven cases, there was only one minor complication, a benign pin-site infection. There were neither neurovascular complication nor loss of reduction. Solid bone healing was obtained in all patients after an average of 5.2 months (range, 2.5 to 6 months). External fixation is a form of "biologic" fixation, as there is no implant apposed on the bone fragments, preventing their revascularization. This easy technique allows to correct the preoperative deformity while providing sufficient stability to allow active mobilization. Temporary elbow bridging does not seem to cause significant stiffening of the joint.

摘要

肱骨髁上骨不连采用内固定难以愈合。人工关节置换术是老年患者的一种解决办法。在感染情况下,这两种治疗选择均为禁忌。本文报道了自体骨移植以及霍夫曼氏肱骨 - 肱骨和临时肱骨 - 尺骨霍夫曼外固定术。在我们的7例病例系列中,仅出现1例轻微并发症,即良性针道感染。未发生神经血管并发症,也没有复位丢失情况。所有患者平均在5.2个月(范围为2.5至6个月)后均实现了牢固的骨愈合。外固定是一种“生物”固定形式,因为没有植入物附着在骨碎片上,从而避免了骨碎片的再血管化受到影响。这种简便技术能够矫正术前畸形,同时提供足够稳定性以允许进行主动活动。临时肘关节桥接似乎不会导致关节明显僵硬。

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