Oliveira Ricardo Kaempf de, Brunelli João Pedro Farina, Aita Márcio Aurelio, Delgado Serrano Pedro José
Grupo de Cirurgia de Mão, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil.
Hospital Mãe de Deus de Porto Alegre, Porto Alegre, RS, Brasil.
Rev Bras Ortop (Sao Paulo). 2020 Dec 18;58(3):532-537. doi: 10.1055/s-0040-1716757. eCollection 2023 Jun.
Synostosis is a generic term to indicate the union of two originally separated bones. At the elbow, humeroradial or longitudinal synostosis causes significant disability, which varies depending on hand function, elbow positioning, adjacent joints mobility and contralateral limb function. It is estimated that, to date, a little more than 150 patients have been described with this deformity, which is more common in subjects with deficient ulnar formation or affected by conditions such as Antley-Bixler and Hermann syndromes. The lack of the elbow joint, with the formation of a longer bone due to humerus-radius fusion, results in stiffness. As such, it is assumed that fractures in this topography are not uncommon. However, since synostosis is rare, this lesion was only described twice in the literature. We report two patients with a fracture of the single bone formed by a humeroradial synostosis and Bayne type-IV ulnar formation failure. Both patients were treated surgically with success. We emphasize the need for adequate treatment to not compromise the daily activities of patients who are adapted to their deformity, thus avoiding worsening the function of a previously affected limb.
骨性连接是一个通用术语,用于表示两块原本分离的骨头的融合。在肘部,肱桡关节骨性连接或纵向骨性连接会导致严重残疾,残疾程度因手部功能、肘部位置、相邻关节活动度和对侧肢体功能而异。据估计,迄今为止,已有150多名患者被描述患有这种畸形,这种畸形在尺骨发育不全或患有安特利-比克斯勒综合征和赫尔曼综合征等疾病的患者中更为常见。由于肱桡融合导致形成一根更长的骨头,肘关节的缺失会导致僵硬。因此,人们认为这种部位的骨折并不罕见。然而,由于骨性连接很少见,这种病变在文献中仅被描述过两次。我们报告了两名患有由肱桡关节骨性连接形成的单骨骨折和贝恩IV型尺骨发育不全的患者。两名患者均接受了手术治疗并取得成功。我们强调需要进行充分治疗,以免影响已适应畸形的患者的日常活动,从而避免使先前受影响肢体的功能恶化。