Wu Chunxing, Wang Dahui, Mo Yueqiang, Zhang Zhiqiang, Ning Bo
Department of Pediatric Orthopedics, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
Front Pediatr. 2022 Aug 9;10:737823. doi: 10.3389/fped.2022.737823. eCollection 2022.
Congenital malformation, trauma, tumor, or metabolic disease can cause length deformity of the radius or ulna, affecting the appearance and function of the forearm. Osteotomy and lengthening with external fixation can obviously improve the length of the radius and ulna (LRU). However, the extent of lengthening required is still unclear. This study analyzed the LRU in children, to provide suggested standards for various orthopedic treatments.
Normal LRUs were measured on X-ray images in children who came to hospital for emergency treatment, with measurements including anterior-posterior (AP) radiographs, lateral (LAT) radiographs, full LRU (total length), and LRU without the epiphysis (short length). Any cases of fracture or deformity affecting measurement were excluded. Three hundred twenty-six cases were divided into 16 groups according to age from 1 year old to 16 years old.
The earliest epiphyseal plate and ossification center were observed in the distal part of the radius at 1 year old, and in the proximal part at 3 years old in both boys and girls. In the ulna, at the distal end it was 6 years old in girls and 7 years old in boys, while in the proximal part ossification was observed at 9 years old in both boys and girls. The proximal epiphyseal plate of the ulna began to close on X-ray images at 12 years old in girls and 13 years in boys. LRU increased with age, and there was a strong positive correlation and consistent ratio between radius, ulna and age. In short length, the ratio of the length of radius to ulna (RLRU) ranged from 0.8941 to 0.9251 AP, from 0.8936 to 0.9375 LAT. In total length, RLRU ranged from 0.9286 to 0.9508 AP, and 0.9579 to 0.9698 LAT.
The length and epiphyseal ossification of the radius and ulna are associated with age. RLRU is also limited to a certain range and tends to remain stable with age. These characteristics have clinical significance for deformity correction of the forearm.
先天性畸形、创伤、肿瘤或代谢性疾病可导致桡骨或尺骨长度畸形，影响前臂的外观和功能。截骨术及外固定延长术可明显增加桡骨和尺骨的长度（LRU）。然而，所需的延长程度仍不明确。本研究分析儿童的LRU，为各种骨科治疗提供建议标准。
对因急诊入院的儿童的X线图像测量正常LRU，测量包括前后位（AP）X线片、侧位（LAT）X线片、完整LRU（全长）及不包括骨骺的LRU（短长度）。排除任何影响测量的骨折或畸形病例。326例根据年龄从1岁至16岁分为16组。
男孩和女孩均在1岁时最早在桡骨远端观察到骨骺板和骨化中心，3岁时在近端观察到。在尺骨，女孩远端为6岁，男孩为7岁，而在近端，男孩和女孩均在9岁时观察到骨化。尺骨近端骨骺板在女孩12岁、男孩13岁时在X线图像上开始闭合。LRU随年龄增加，桡骨、尺骨与年龄之间存在强正相关且比例一致。在短长度时，桡骨与尺骨长度之比（RLRU）在AP位为0.8941至0.9251，在LAT位为0.8936至0.9375。在全长时，RLRU在AP位为0.9286至0.9508，在LAT位为0.9579至0.9698。
桡骨和尺骨的长度及骨骺骨化与年龄相关。RLRU也局限于一定范围，且随年龄趋于稳定。这些特征对前臂畸形矫正具有临床意义。
