成人创伤后肘内翻的平移截骨术：一项回顾性研究。
Translation step-cut osteotomy for posttraumatic Cubitus Varus in adults: a retrospective study.
作者信息
Kim Jung Ryul, Moon Yoong Jae, Wang Sung Il
机构信息
Department of Orthopaedics Surgery, Jeonbuk National University Medical School, Research Insitute for Endocrine Sciences and Research Insitute of Clinical Medicine of Jeonbuk National University-Biomedical Research Insitute of Jeonbuk National University Hospital, 567 Baekje-ro, Dukjin-gu, Jeonju, 561-756, Republic of Korea.
Department of Biochemistry and Molecular Biology, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital and Research Institute for Endocrine Sciences, Jeonju, Jeonbuk, 54896, Republic of Korea.
出版信息
BMC Musculoskelet Disord. 2020 Dec 7;21(1):820. doi: 10.1186/s12891-020-03845-7.
BACKGROUND
Cubitus varus is a complex three-dimensional deformity. Various osteotomies have been introduced to correct this complex deformity. The objective of the present study was to evaluate clinical and functional outcomes of adult cubitus varus deformity treated with translation step-cut osteotomy.
METHODS
Seventeen consecutive patients with a mean age of 25 years (range, 19-50 years) who underwent translation step-cut osteotomy were enrolled in this study. Their average follow-up period was 28.2 months. Radiographic measurements preoperatively, 3-month postoperatively, and at the last follow-up were compared. Functional outcomes were assessed using Disabilities of the Arm, Shoulder and Hand (DASH), Mayo Elbow Performance Score (MEPS), and Oppenheim criteria.
RESULTS
The mean humerus-elbow-wrist angle improved from 14.7° ± 6.4° (range, 6°-23°) varus preoperatively to 12.1° ± 6.6° (range, 5°-20°) valgus postoperatively (p < 0.001). The lateral prominence index improved 9.6% from its preoperative value, showing no significant difference from that of a normal elbow. Osseous union was radiographically demonstrated in 16 patients (except one out of 17 patients) within a mean of 12.7 weeks (range, 8-18 weeks). The motion arc of the elbow at the last follow-up was not significantly (p > 0.05) different from that at the initial presentation. Based on Oppenheim criteria, results were excellent for 7, good for 8, and poor for 2 patients. Mean final DASH value and MEPS were 2.5 ± 3.8 points (range, 0-15 points) and 97.0 ± 5.8 points (range, 85-100 points), respectively. With regard to complications, one case had delayed union and one case had transient radial nerve injury.
CONCLUSION
Translation step-cut osteotomy using Y plate is an efficient procedure to correct varus alignment and flexion-extension deformities so that they are within normal limits of adults with post-traumatic cubitus varus deformity.
TRIAL REGISTRATION
Institutional Review Board of Jeonbuk National University Hospital (IRB No. 2020-01-020 ).
背景
肘内翻是一种复杂的三维畸形。已引入各种截骨术来纠正这种复杂畸形。本研究的目的是评估经平移阶梯截骨术治疗成人肘内翻畸形的临床和功能结果。
方法
本研究纳入了17例连续接受平移阶梯截骨术的患者，平均年龄25岁（范围19 - 50岁）。他们的平均随访期为28.2个月。比较术前、术后3个月和最后一次随访时的影像学测量结果。使用手臂、肩部和手部功能障碍（DASH）、梅奥肘关节功能评分（MEPS）和奥本海姆标准评估功能结果。
结果
平均肱骨 - 肘 - 腕角从术前内翻14.7°±6.4°（范围6° - 23°）改善为术后外翻12.1°±6.6°（范围5° - 20°）（p < 0.001）。外侧突出指数较术前值改善了9.6%，与正常肘关节无显著差异。16例患者（17例患者中的16例）在平均12.7周（范围8 - 18周）内影像学显示骨愈合。最后一次随访时肘关节的活动弧与初次就诊时无显著差异（p > 0.05）。根据奥本海姆标准，7例患者结果为优，8例为良，2例为差。最终平均DASH值和MEPS分别为2.5±3.8分（范围0 - 15分）和97.0±5.8分（范围85 - 100分）。关于并发症，1例发生延迟愈合，1例发生短暂性桡神经损伤。
结论
使用Y形钢板的平移阶梯截骨术是一种有效的手术方法，可将创伤后肘内翻畸形成人的内翻对线和屈伸畸形纠正至正常范围内。
试验注册
全北国立大学医院机构审查委员会（IRB编号2020 - 01 - 020）
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