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儿童先天性桡尺骨融合的影像学表现与临床特征的关系:一项多中心回顾性研究

The relation between radiographic manifestation and clinical characteristics of congenital radioulnar synostosis in children: A retrospective study from multiple centers.

作者信息

Hong Pan, Tan Wei, Zhou Wei-Zheng, Zheng Yu, Li Jin, Zheng PengFei, Tang Xin

机构信息

Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Pediatric Orthopedic, Center for Orthopedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.

出版信息

Front Pediatr. 2023 Mar 3;11:1117060. doi: 10.3389/fped.2023.1117060. eCollection 2023.

Abstract

OBJECTIVE

To review the radiographic manifestation and clinical appearance of children with congenital radioulnar synostosis (CRUS) retrospectively.

STUDY DESIGN

Retrospective cohort study of children with CRUS from multiple medical centers.

RESULTS

A total of 329 patients (male 259, female 70) with an average age of 5.4 years (0.5-16 years old), were included in this study. In particular, 145 patients (145/329, 44.1%) demonstrated bilateral involvement, and 184 patients (left 123, right 61) demonstrated unilateral involvement. As for Clear and Omery (C&O) classification, most patients belonged to Type III, and then followed by Type IV. As for Chinese Multi-center Pediatric Orthopedic Study Group (CMPOS) classification, most patients belonged to Type III, and then followed by Type II and Type I. In C&O Type III, 92.03% patients demonstrated severe pronation. According to CMPOS classification, 92.98% Type I patients demonstrated neutral to mild pronation, 72.17% Type II patients demonstrated moderate pronation, and 92.03% Type III patients demonstrated severe pronation. The age distribution showed no significant difference between C&O Type II and IV ( = 0.96); the pronation ankylosis severity showed no significant difference between C&O Type II and IV ( = 0.387).

CONCLUSION

Although CRUS is a rare forearm deformity, there are certain relation between radiographic manifestation and clinical forearm functional restriction. CRUS patients of C&O or CMPOS Type III classification might suffer severe pronation deformity and warrant early intervention.

摘要

目的

回顾性分析先天性桡尺骨融合(CRUS)患儿的影像学表现及临床症状。

研究设计

对来自多个医疗中心的CRUS患儿进行回顾性队列研究。

结果

本研究共纳入329例患者(男259例,女70例),平均年龄5.4岁(0.5 - 16岁)。其中,145例患者(145/329,44.1%)为双侧受累,184例患者(左侧123例,右侧61例)为单侧受累。在Clear和Omery(C&O)分类中,大多数患者属于III型,其次是IV型。在中国多中心小儿骨科研究组(CMPOS)分类中,大多数患者属于III型,其次是II型和I型。在C&O III型中,92.03%的患者表现为严重旋前。根据CMPOS分类,92.98%的I型患者表现为中立至轻度旋前,72.17%的II型患者表现为中度旋前,92.03%的III型患者表现为严重旋前。年龄分布在C&O II型和IV型之间无显著差异(= 0.96);旋前强直严重程度在C&O II型和IV型之间无显著差异(= 0.387)。

结论

尽管CRUS是一种罕见的前臂畸形,但影像学表现与临床前臂功能受限之间存在一定关系。C&O或CMPOS III型分类的CRUS患者可能会出现严重的旋前畸形,需要早期干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/950c/10020496/16dd68f57767/fped-11-1117060-g001.jpg

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