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小儿肘内翻畸形张力带接骨术的评估:一项回顾性研究。

Evaluation of tension-band osteosynthesis for cubitus varus deformity in pediatric patients: A retrospective review.

作者信息

Minh Phan Man Duc, Light Terry Richard, Van Phan Tiep, Nguyen Phi Duong

机构信息

Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam.

Loyola University Medical Center, Illinois, United States.

出版信息

J Hand Microsurg. 2025 Jan 3;17(2):100213. doi: 10.1016/j.jham.2025.100213. eCollection 2025 Mar.

Abstract

PURPOSE

This study aims to evaluate the effectiveness and safety of lateral closing wedge osteotomy with tension-band wire fixation for correcting cubitus varus deformity in pediatric patients. The primary objective was to assess the bone union rate, functional outcomes, and potential complications associated with this surgical approach.

METHODS

We conducted a retrospective review of 104 pediatric cases (ages 7-15) with post-traumatic cubitus varus deformity treated between January 2018 and December 2019 at the Pediatric Orthopedic Department. The surgical technique involved a lateral closing wedge osteotomy with fixation achieved using an 8-figure tension-band wire on the lateral column of the distal humerus. Follow-up assessments were conducted for bone union, correction stability, range of motion, and any post-surgical complications.

RESULTS

Out of 104 cases, 63 involved left elbows and 41 right elbows, with an average patient age of 8.12 years. The deformity was severe (>30° varus) in 33.65 % of cases. Successful correction and bone union were achieved in 100 % of cases, with an average follow-up duration of 8 months (range: 3-20 months). Complications included minor recurrence in two cases due to early post-operative trauma, limited range of motion in three cases, K-wire protrusion in three cases, and infection in two cases. Functional outcomes rated as excellent in 94.2 % of cases and good in 5.8 %.

CONCLUSION

Lateral closing wedge osteotomy with tension-band wire fixation is a reliable technique for correcting pediatric cubitus varus deformity, offering stable fixation, high success rates in bone healing, and favorable functional outcomes with minimal complications.

摘要

目的

本研究旨在评估外侧闭合楔形截骨术联合张力带钢丝固定矫正小儿肘内翻畸形的有效性和安全性。主要目的是评估这种手术方法的骨愈合率、功能结果以及潜在并发症。

方法

我们对2018年1月至2019年12月在小儿骨科接受治疗的104例(年龄7 - 15岁)创伤后肘内翻畸形患儿进行了回顾性研究。手术技术包括外侧闭合楔形截骨术,通过在肱骨远端外侧柱使用8字张力带钢丝进行固定。对骨愈合、矫正稳定性、活动范围以及任何术后并发症进行了随访评估。

结果

104例中,63例为左侧肘部,41例为右侧肘部,患者平均年龄为8.12岁。33.65%的病例畸形严重(内翻>30°)。100%的病例成功矫正并实现骨愈合,平均随访时间为8个月(范围:3 - 20个月)。并发症包括2例因术后早期创伤导致的轻度复发、3例活动范围受限、3例克氏针突出以及2例感染。94.2%的病例功能结果评为优秀,5.8%评为良好。

结论

外侧闭合楔形截骨术联合张力带钢丝固定是矫正小儿肘内翻畸形的可靠技术,提供稳定的固定、高骨愈合成功率以及良好的功能结果,并发症最少。

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