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桡骨头骨折后近端桡尺关节融合:手术切除及肱三头肌外侧头肌瓣嵌入术以恢复功能

Proximal Radioulnar Synostosis Post-radial Head Fracture: Surgical Excision and Anconeus Muscle Flap Interposition for Functional Restoration.

作者信息

Singh Deepak, Lim Chia Hua, Abdullah Shalimar, Sapuan Jamari, Soh Elaine Zi Fan

机构信息

Hand and Microsurgery Unit, Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS.

出版信息

Cureus. 2025 Apr 22;17(4):e82783. doi: 10.7759/cureus.82783. eCollection 2025 Apr.

Abstract

Adult proximal radioulnar synostosis is a rare complication where its manifestation is due to either post-surgery or post-traumatic effect causing limitation in the function of the forearm especially in supination and pronation. Most common occurrences of synostosis over the forearm region can be divided based on anatomical location, which involves the distal third, middle third, and proximal third forearm region. We report the case of a 42-year-old woman who developed proximal radioulnar synostosis following a conservatively treated radial head fracture 18 months earlier. She presented with pain and restricted forearm rotation during heavy lifting. Surgical excision of the synostosis with anconeus muscle flap interposition was performed. Four months postoperatively, the patient demonstrated improved pronation and supination with no further complaints. Surgical intervention should be considered in adult cases where forearm rotation is compromised.

摘要

成人近端桡尺关节融合是一种罕见的并发症,其表现是由于手术或创伤后效应导致前臂功能受限,尤其是旋前和旋后功能。前臂区域融合的最常见发生情况可根据解剖位置进行划分,涉及前臂远端三分之一、中间三分之一和近端三分之一区域。我们报告了一例42岁女性的病例,她在18个月前桡骨头骨折接受保守治疗后出现了近端桡尺关节融合。她在重物搬运时出现疼痛和前臂旋转受限。进行了融合部位的手术切除并置入肘肌瓣。术后四个月,患者的旋前和旋后功能有所改善,且无进一步不适主诉。对于前臂旋转受限的成人病例,应考虑手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b36/12098752/58e479469887/cureus-0017-00000082783-i01.jpg

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