Kruppa Christiane, Brinkemper Alexis, Cibura Jana, Königshausen Matthias, Cibura Charlotte, Schildhauer Thomas A, Dudda Marcel
Department of General and Trauma Surgery, BG University Hospital Bergmannsheil Bochum, Ruhr University Bochum, Bochum, Germany.
Orthopaedic Clinic, Klinikum Dortmund gGmbH, Teaching Hospital of the University of Witten/Herdecke, Dortmund, Germany.
J Child Orthop. 2023 Apr 16;17(3):239-248. doi: 10.1177/18632521231167395. eCollection 2023 Jun.
Purpose of the study was to report the outcomes after radial head excision in children and adolescents in addition with a review of the current literature.
We report a series of five children and adolescents, who had undergone a post-traumatic radial head excision. Clinical outcomes were evaluated in terms of elbow/wrist range of motion, stability, deformity and discomforts or restrictions at two follow-up points. Radiographic changes were evaluated.
Patient's age at time of the radial head excision averaged 14.6 (13-16) years. Mean time from the injury to the radial head excision was 3.6 (0-9) years. Follow-up I averaged 4.4 (1-8) years and follow-up II 8.5 (7-10) years. At follow-up I, patients showed an average elbow range of motion of 0-10-120° Ext/Flex and 90-0-80° Pro/Sup. Two patients reported discomfort or pain at the elbow. Four (80%) patients had a symptomatic wrist with pain or crepitation at the distal radio ulnar joint. In three (60%) of them, an ulna plus at the wrist was present. Two patients required ulna shortening and autograft stabilization of the interosseous membrane. At final follow-up, all patients reported full functioning with daily activities. Restrictions were present with sport activities.
Functional results at the elbow joint might be improved and pain syndromes lessen due to the radial head excision. Problems at the wrist are likely secondary to the procedure. A critical analysis of other options should be performed ahead of the procedure and a careless application should be avoided by all means.
IV.
本研究的目的是报告儿童和青少年桡骨头切除术后的结果，并对当前文献进行综述。
我们报告了一系列5例接受创伤后桡骨头切除术的儿童和青少年。在两个随访点，根据肘/腕关节活动范围、稳定性、畸形以及不适或限制情况对临床结果进行评估。对影像学变化进行评估。
桡骨头切除时患者的平均年龄为14.6（13 - 16）岁。从受伤到桡骨头切除的平均时间为3.6（0 - 9）年。随访I平均为4.4（1 - 8）年，随访II平均为8.5（7 - 10）年。在随访I时，患者的肘关节平均活动范围为伸/屈0 - 10 - 120°，旋前/旋后90 - 0 - 80°。2例患者报告肘部有不适或疼痛。4例（80%）患者的腕关节有症状，表现为远端桡尺关节疼痛或摩擦音。其中3例（60%）存在腕部尺骨阳性变异。2例患者需要进行尺骨短缩和自体骨移植以稳定骨间膜。在最终随访时，所有患者均报告日常活动功能正常。体育活动存在限制。
桡骨头切除可能会改善肘关节的功能结果并减轻疼痛综合征。腕部问题可能是该手术的继发性问题。在手术前应对其他选择进行批判性分析，并且应尽量避免草率应用。
IV级。
