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观察外固定架重建前臂旋转功能治疗先天性尺桡骨融合的效果。

Observation on the effect of reconstruction of the forearm rotation function with an external fixator in the treatment of congenital radioulnar synostosis.

机构信息

Department of Pediatric Orthopaedics, Third Affiliated Hospital of Zhengzhou University, Kangfuqianjie Road, Zhengzhou, 450000, Henan, China.

出版信息

J Orthop Surg Res. 2024 Oct 4;19(1):625. doi: 10.1186/s13018-024-05112-0.

DOI:10.1186/s13018-024-05112-0
PMID:39367497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11453056/
Abstract

PURPOSE

To observe the effect of the forearm rotation function reconstruction with an external fixator in treating congenital radioulnar synostosis.

METHODS

From July 2017 to July 2023, 6 patients (9 sides) with congenital radioulnar synostosis who underwent reconstruction of the forearm rotation with the external fixator were retrospectively analyzed. The extent of flexion and rotation, the Modified An and Morrey functional rating index, and the grade according to the classification system proposed by Failla et al. were compared before and after the operation.

RESULTS

All patients were followed up for an average of 12.00 (8.00, 38.50) months. The average range of rotation, the Modified An and Morrey functional rating index increased from 0°, 64.56 ± 1.33 points to 85.00° ± 25.86°, 83.71 ± 5.50 points, respectively. The differences were statistically significant (t = 9.86, P < 0.01, t = 11.20, P < 0.01). There was no significant difference in forearm flexion before and after the operation (Z = 1.34, P = 0.18). According to the Failla classification system, 2 forearms were classified as poor preoperatively, 6 as fair and 1 as good. 2 forearms were assessed as excellent, 6 as good and 1 as fair during the last follow-up.

CONCLUSION

Reconstruction of the forearm rotation function with an external fixator is safe and effective for treating congenital radioulnar synostosis. This technique can restore the partial rotational function of the forearm.

摘要

目的

观察外固定架治疗先天性尺桡骨融合的前臂旋转功能重建效果。

方法

回顾性分析 2017 年 7 月至 2023 年 7 月采用外固定架治疗先天性尺桡骨融合患者 6 例(9 侧),比较术前、术后的前臂旋转活动度、改良 An 和 Morrey 功能评分以及 Failla 等提出的分类系统分级。

结果

所有患者均获得平均 12.00(8.00,38.50)个月随访。旋转活动度、改良 An 和 Morrey 功能评分平均由 0°、64.56±1.33 分增加至 85.00°±25.86°、83.71±5.50 分,差异均有统计学意义(t=9.86,P<0.01;t=11.20,P<0.01)。术后前臂屈伸差异无统计学意义(Z=1.34,P=0.18)。按 Failla 分类系统,术前 2 侧为差,6 侧为中,1 侧为优;末次随访时,2 侧为优,6 侧为良,1 侧为中。

结论

外固定架治疗先天性尺桡骨融合安全、有效,可重建前臂部分旋转功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/93e8370fb90a/13018_2024_5112_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/7b1ad5309b7c/13018_2024_5112_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/190ca08ab6b2/13018_2024_5112_Fig2_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/c9950397be93/13018_2024_5112_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/93e8370fb90a/13018_2024_5112_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/7b1ad5309b7c/13018_2024_5112_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/190ca08ab6b2/13018_2024_5112_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/c1293b6bcda6/13018_2024_5112_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/c9950397be93/13018_2024_5112_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11453056/93e8370fb90a/13018_2024_5112_Fig5_HTML.jpg

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本文引用的文献

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2
Corrective derotation osteotomies to treat congenital radioulnar synostosis in children: results of a systematic review and meta-analysis.儿童先天性桡尺骨融合的矫正性旋转截骨术:系统评价与荟萃分析结果
Indian J Orthop. 2022 Jan 21;56(5):717-740. doi: 10.1007/s43465-021-00582-4. eCollection 2022 May.
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Congenital Radioulnar Synostosis.
先天性尺桡骨融合
J Am Acad Orthop Surg. 2021 Jul 1;29(13):563-570. doi: 10.5435/JAAOS-D-20-01133.
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Congenital unilateral proximal radioulnar synostosis: A surgical case report.先天性单侧近端桡尺关节融合:一例手术病例报告。
Medicine (Baltimore). 2020 Apr;99(16):e19782. doi: 10.1097/MD.0000000000019782.
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Radial Pronation Angle: A Novel Radiological Evaluation Index of Congenital Proximal Radioulnar Synostosis.桡骨旋前角:先天性近端桡尺关节融合的一种新型影像学评估指标。
Ann Plast Surg. 2020 May;84(5S Suppl 3):S196-S201. doi: 10.1097/SAP.0000000000002368.
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