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马德隆畸形的初次桡骨矫正性截骨术的结果。

Results of primary radial corrective osteotomy in Madelung's deformity.

机构信息

Department of Hand Surgery, RHÖN-KLINIKUM Campus Bad Neustadt, Von-Guttenberg-Str. 11, 97616, Bad Neustadt an der Saale, Germany.

出版信息

Arch Orthop Trauma Surg. 2023 May;143(5):2797-2803. doi: 10.1007/s00402-022-04731-8. Epub 2022 Dec 24.

Abstract

INTRODUCTION

The purpose of this study was the evaluation of surgical outcomes in a series of wrists with Madelung's deformity treated with radial corrective osteotomy. We hypothesize that this surgical technique is a suitable and safe way of treatment.

MATERIALS AND METHODS

A retrospective review of patients with Madelung's deformity treated with radial corrective osteotomy between January 2001 and June 2017 at a single large department of hand surgery in Germany was performed. Patients who met the inclusion criteria were invited for follow-up and outcome variables including pain, range of motion, patient-rated outcome measures, and radiographic measurements were obtained for comparison with preoperative data collected from the patients' medical records.

RESULTS

14 wrists were included. The average age at the time of surgery was 21.9 years, and the average follow-up was 7.2 years. The average visual analog pain scale at rest decreased from preoperative 2.6 points to postoperative 0.7 points. Under strain, the average VAS declined from 7.4 to 4.9 points. The mean DASH Score decreased from 42.9 before surgery to 22.0 points after surgery. Range of motion improved slightly in five out of six directions of motion, with the greatest increase seen in average supination from preoperative 68.5° to postoperative 82.0°. Averages of all five measured McCarroll's parameters and ulnar variance decreased, as expected from corrective surgery. Four wrists (26.8%) needed subsequent procedures.

CONCLUSION

Radial corrective osteotomy was a suitable treatment of Madelung's deformity in our collective, although surgical outcomes are not yet fully satisfying.

摘要

简介

本研究的目的是评估一组接受桡骨矫正性截骨术治疗的马德隆畸形手腕的手术结果。我们假设这种手术技术是一种合适且安全的治疗方法。

材料与方法

对 2001 年 1 月至 2017 年 6 月期间在德国一家大型手外科部门接受桡骨矫正性截骨术治疗的马德隆畸形患者进行了回顾性研究。符合纳入标准的患者被邀请进行随访,并获得了包括疼痛、活动范围、患者自评结果测量和影像学测量在内的结果变量,与从患者病历中收集的术前数据进行比较。

结果

共纳入 14 例手腕。手术时的平均年龄为 21.9 岁,平均随访时间为 7.2 年。平均静息视觉模拟疼痛评分从术前 2.6 分降至术后 0.7 分。在受力下,平均 VAS 从 7.4 分降至 4.9 分。DASH 评分从术前的 42.9 分降至术后的 22.0 分。在六个运动方向中的五个方向上,运动范围都略有改善,平均旋前从术前 68.5°增加到术后 82.0°。正如预期的那样,所有五个测量的 McCarroll 参数和尺侧偏距的平均值都有所下降。4 例(26.8%)需要进行后续手术。

结论

桡骨矫正性截骨术是治疗马德隆畸形的一种合适方法,尽管手术结果还不完全令人满意。

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