Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Sci Rep. 2022 Apr 21;12(1):6585. doi: 10.1038/s41598-022-09411-6.
Existed classifications of congenital proximal radioulnar synostosis (PRUS) mainly focus on osseous changes and do not cover all types of congenital PRUS, ignoring the role and developing status of the supinator. This study aims to explore the correlation between supinator development and radiographic deformity of congenital PRUS. Pediatric patients diagnosed with congenital PRUS in two pediatric Orthopedic centers were evaluated retrospectively. MRI and radiographic images of their bilateral forearms (including normal ones) were collected. The area of supinator, extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), brachioradialis (BRAR) muscle and extensor indicis (EI) muscle were measured on each forearm. The ratios of these muscles were calculated and regarded as an indicator of the developing status of supinator muscle. Twenty-seven congenital PRUS forearms of 16 patients (average 3.45 years) were included. A new MRI & X-ray classification system was proposed to cover all types of radiographic deformity and provide a comprehensive description of supinator development. This study revealed the relation between MRI measured supinator volume and radiographic deformity of congenital PRUS. Supinator muscles were observed in all congenital PRUS cases. A novel classification was proposed, providing a more comprehensive understanding of congenital PRUS.
已存在的先天性近侧桡尺骨融合（PRUS）分类主要集中在骨骼变化上，并未涵盖所有类型的先天性 PRUS，忽略了旋后肌的作用和发育状态。本研究旨在探讨先天性 PRUS 中旋后肌发育与放射影像学畸形之间的相关性。在两个儿科骨科中心回顾性评估了被诊断为先天性 PRUS 的儿科患者。收集了他们双侧前臂（包括正常的）的 MRI 和 X 线图像。测量了每只前臂的旋后肌、桡侧腕长伸肌（ECRL）、桡侧腕短伸肌（ECRB）、肱桡肌（BRAR）和示指伸肌（EI）的面积。计算这些肌肉的比例，并将其视为旋后肌发育状况的指标。纳入了 16 名患者的 27 只先天性 PRUS 前臂（平均 3.45 岁）。提出了一种新的 MRI 和 X 线分类系统，以涵盖所有类型的放射影像学畸形，并提供对旋后肌发育的全面描述。本研究揭示了 MRI 测量的旋后肌体积与先天性 PRUS 放射影像学畸形之间的关系。在所有先天性 PRUS 病例中均观察到了旋后肌。提出了一种新的分类方法，为先天性 PRUS 提供了更全面的认识。
