Mercier Julie, Bernasconi Reto, Steiger Christina, Kaempfen Alexandre, Krieg Andreas H
Plastic, Reconstructive, Esthetic and Hand Surgery, Centre Hospitalier Universitaire Vaudevoise, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
Anesthesiology Service, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900 Lugano, Switzerland.
J Clin Med. 2023 Jun 26;12(13):4273. doi: 10.3390/jcm12134273.
Prevention of rotatory impairment and radial head dislocation in the forearm is an important aspect when treating children with osteochondromas. Various studies tried to determine the best treatment, describing different surgical techniques. No consensus has been reached yet. This retrospective study compares the treatment outcome of patients with osteochondroma of the radius and ulna after surgical or conservative treatment. Seventeen forearms treated over a period of 20 years were analysed. Outcome parameters were the prospectively collected clinical data and the radiological findings: "relative shortening" of ulna/radius, the "radial articular angle" (RAA) and the "carpal slip" (CS). Our study shows an improvement of the range of motion and cosmetic appearance of the forearm after an operative procedure, with or without bone lengthening. We observed an increase in wrist and elbow mobility with a decrease in pain scores and a confirmed high cosmetic satisfaction in almost 70% of the patients after bone lengthening and up to 85% after simple excision. For patients suffering from functional impairment or pain, an operative approach is beneficial. Multiple and repetitive osteochondroma excisions are recommended during growth to prevent deformity and rotatory motion restriction. Lengthening procedures require a careful indication.
在治疗患有骨软骨瘤的儿童时，预防前臂旋转功能障碍和桡骨头脱位是一个重要方面。各种研究试图确定最佳治疗方法，描述了不同的手术技术。但尚未达成共识。这项回顾性研究比较了桡骨和尺骨骨软骨瘤患者手术治疗或保守治疗后的结果。分析了20年间治疗的17例前臂病例。结果参数为前瞻性收集的临床数据和影像学表现：尺骨/桡骨的“相对缩短”、“桡骨关节角”（RAA）和“腕骨滑移”（CS）。我们的研究表明，无论是否进行骨延长手术，术后前臂的活动范围和外观均有改善。我们观察到，延长术后腕关节和肘关节活动度增加，疼痛评分降低，近70%接受骨延长手术的患者和高达85%接受单纯切除手术的患者对外观满意度较高。对于有功能障碍或疼痛的患者，手术治疗有益。建议在生长期间多次重复切除骨软骨瘤，以防止畸形和旋转运动受限。延长手术需要谨慎掌握适应症。
