Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Beijing, China.
Orthop Surg. 2023 May;15(5):1348-1356. doi: 10.1111/os.13701. Epub 2023 Mar 23.
The deformity of congenital radioulnar synostosis is quite complicated and difficult. This study aims to find out the related factors of the "forearm rotation angle" (FR) which relate to the severity of congenital radioulnar synostosis (CRUS), and try to quantify the internal relations of each deformity and help to understand the reconstruction method in surgery treatment of this disease.
This study is case series research. We established 48 digital three-dimensional forearm bone models of 48 patients with congenital radioulnar synostosis classified as Cleary and Omer type 3. All the patients were treated at our institution from January 2010 to June 2016. In total, 10 independent deformities (the rotation angle of forearm; the internal rotation, radial, and dorsal angulation of radius and ulna; the relative length of osseous fusion at PRUJ; the relative dislocation distance of distal radioulnar joint; the relative area of proximal radial epiphysis) involved in the CRUS complex deformity were measured. Pearson correlation analysis for each deformity which was mentioned above was performed, and multivariate linear regression analysis was also performed with FR as the dependent variable and the other deformities as the influential factors.
The "dorsal angle of radius" (DAR, 21.69° ± 21.55°) had the strongest correlation with the FR (79.72° ± 40.39°), the Pearson correlation coefficient was 0.601 (p < 0.01), the internal rotation angle of the radius (IRAR, 82.69° ± 54.98°) had a moderate correlation with FR, the Pearson correlation coefficient was 0.552 (p < 0.01). A forearm deformity equation was established: FR = 35.896 + 0.271 DAR + 0.989 IRAR.
The dorsal angulation deformity of radius may be the most important deformity that effects the severity of CRUS and should be correct in the first place during reconstruction operation.
先天性尺桡骨融合的畸形较为复杂和困难。本研究旨在找出与先天性尺桡骨融合（CRUS）严重程度相关的“前臂旋转角度”（FR）的相关因素，并尝试量化每种畸形之间的内在关系，帮助理解该疾病手术治疗中的重建方法。
本研究为病例系列研究。我们建立了 48 例先天性尺桡骨融合患者的 48 个数字三维前臂骨模型，根据 Cleary 和 Omer 分类法为 3 型。所有患者均于 2010 年 1 月至 2016 年 6 月在我院接受治疗。总共测量了 10 种独立的畸形（前臂旋转角度；桡骨和尺骨的内旋、桡骨和尺骨的掌侧、背侧成角；PRUJ 处骨融合的相对长度；桡尺远侧关节的相对脱位距离；桡骨近端干骺端的相对面积）与 CRUS 复杂畸形有关。对上述每种畸形进行 Pearson 相关性分析，并以 FR 为因变量，以其他畸形为影响因素进行多元线性回归分析。
“桡骨背侧角”（DAR，21.69°±21.55°）与 FR（79.72°±40.39°）相关性最强，Pearson 相关系数为 0.601（p<0.01），桡骨内旋角（IRAR，82.69°±54.98°）与 FR 呈中度相关，Pearson 相关系数为 0.552（p<0.01）。建立了一个前臂畸形方程：FR=35.896+0.271DAR+0.989IRAR。
桡骨背侧成角畸形可能是影响 CRUS 严重程度的最重要畸形，在重建手术中应首先矫正。
