Xiao Han, Xiao Baohui, Tan Xiaoqian, Tan Qian, Ye Weihua, Wu Jiangyan, Li Renfei, Mei Haibo, Zhu Guanghui, Yan An
The Affiliated Children's Hospital of Xiangya School of Medicine,Central South University (Hunan children's hospital), Changsha, Hunan, China.
Hunan Provincial Key Laboratory of Pediatric Orthopedics, Changsha, Hunan, China.
J Child Orthop. 2025 Jul 26;19(4):321-328. doi: 10.1177/18632521251358639. eCollection 2025 Aug.
The premature closure of the epiphysis of the distal radius is an infrequent condition in pediatric patients, often resulting in distal radius deformity. Currently, there is limited literature on its treatment, and controversy exists. This study aimed to evaluate the clinical efficacy of all-inside physeal bar resection with the aid of an arthroscope and patient-specific instrument.
We retrospectively reviewed the patients who sustained distal radius physeal bar resection under all-inside visualization of the arthroscope with the aid of a patient-specific instrument during 2016-2022. Follow-up was performed for a minimum of 2 years, during which pre-operative and post-operative clinical and radiological parameters were compared.
There were six boys and two girls enrolled in this study. Six patients got satisfied results, while two patients didn't benefit from the surgery. The mean pre-operative RAA of the affected side was -11.4° ± 13°, while the post-operative radial articular angle was 3.4° ± 11°. There was a significant difference between them. The mean pre-operative ulnar variance was 7.6 mm ± 6 mm, while the post-operative UV was 3.3 cm ± 8 mm. There was no significant difference between them. The pre-operative modified Mayo Wrist Score was 92 ± 5, while that for post-operative was 96 ± 7.
All-inside physeal bar resection for partial physeal arrest of the distal radius with the aid of an arthroscopy and patient-specific instrument is minimally invasive, accurate, and safe. It should be the one option treatment for the premature closure of the distal radius epiphysis.
小儿患者桡骨远端骨骺过早闭合是一种罕见的情况，常导致桡骨远端畸形。目前，关于其治疗的文献有限，且存在争议。本研究旨在评估在关节镜和患者特异性器械辅助下全关节镜下骨骺阻滞切除的临床疗效。
我们回顾性分析了2016年至2022年期间在关节镜全关节镜视野下借助患者特异性器械进行桡骨远端骨骺阻滞切除的患者。随访至少2年，比较术前和术后的临床及影像学参数。
本研究共纳入6名男孩和2名女孩。6例患者取得满意结果，2例患者未从手术中获益。患侧术前平均桡骨远端关节角（RAA）为-11.4°±13°，术后桡骨关节角为3.4°±11°。两者之间存在显著差异。术前平均尺骨变异为7.6mm±6mm，术后尺骨变异为3.3mm±8mm。两者之间无显著差异。术前改良梅奥腕关节评分92±5，术后为96±7。
在关节镜和患者特异性器械辅助下对桡骨远端部分骨骺阻滞进行全关节镜下骨骺阻滞切除具有微创、准确和安全的特点。它应是桡骨远端骨骺过早闭合的一种治疗选择。
