Pfister Georges, Le Hanneur Malo, Bachy Manon, Fitoussi Franck
Department of Pediatric Orthopedics, Sorbonne University, Paris, France.
J Hand Surg Eur Vol. 2020 Sep;45(7):729-736. doi: 10.1177/1753193420916694. Epub 2020 Apr 19.
Radial club hand deformities are commonly treated with arthrolysis to allow centralization of the ulna. In this retrospective cohort study of 31 hands in 28 patients, we aimed to assess the outcomes of correction using progressive distraction and subsequent percutaneous pinning of the wrist with a corrective ulnar osteotomy. Mean follow-up time was 7 years (range 2 to 20). The angulation of the hand-forearm complex was decreased after each step of the procedure. Mean correction of the angulation was 64°, and the residual total forearm-hand angulation was 12° after completion of the surgery. At the time of bony maturity (four patients), all wrists had fused. Fifty-eight reoperations were required in 31 wrists because of pin migration or breakage, and in addition 18 secondary osteotomies of the ulna were performed. From this study we conclude that distraction and pinning provide satisfactory and stable realignment of the wrist to correct the deformity, but this treatment has drawbacks regarding the high number of reoperations and the loss of wrist mobility. IV.
桡侧多指畸形通常采用关节松解术治疗，以使尺骨中心化。在这项对28例患者的31只手进行的回顾性队列研究中，我们旨在评估使用渐进性牵引及随后经皮用矫正性尺骨截骨术固定腕关节的矫正效果。平均随访时间为7年（范围2至20年）。在手术的每个步骤后，手-前臂复合体的角度均减小。角度的平均矫正度为64°，手术后残余的前臂-手总角度为12°。在骨成熟时（4例患者），所有腕关节均已融合。31只腕关节因克氏针移位或断裂需要进行58次再次手术，此外还进行了18次尺骨二次截骨术。从本研究中我们得出结论，牵引和克氏针固定能使腕关节获得满意且稳定的重新排列以矫正畸形，但该治疗方法存在再次手术次数多和腕关节活动度丧失等缺点。四。
