Green W T, Mital M A
J Bone Joint Surg Am. 1979 Jul;61(5):738-43.
The results of an operative approach to the problem of radio-ulnar synostosis were assessed in thirteen patients, ten to twenty-five and one-half years after the procedure was performed. We concluded that in a patient with bilateral synostosis one hand, the one not used in writing, should be shifted to a position of 20 to 35 degrees of supination. With one hand in this position, the other may be left in considerable pronation. Often after such a shift it is not necessary to rotate the second arm. However, if the pronation is marked in the second forearm, and if function is impaired unduly by this position, surgical correction is indicated. The arm should be placed in a position of 30 to 45 degrees of pronation. In unilateral radio-unlar synostosis, the ordinarily ideal position of the radius is between 10 and 20 degrees of supination. In an adult, the patient's occupation should be considered in deciding on the rotatory positions of the forearms. We usually prefer a method of transverse osteotomy through the conjoined mass of the radius and ulna. Careful observation of the effect on the vascular status of the limb during and immediately after surgery is important.
对13例接受手术治疗桡尺骨融合问题的患者进行了评估，评估时间为手术实施后的10至25年半。我们得出结论，对于双侧桡尺骨融合的患者，不用于书写的那只手应置于旋前20至35度的位置。一只手处于这个位置时，另一只手可以保持相当程度的旋后。通常在这样的调整后，无需转动另一只手臂。然而，如果第二只前臂旋后明显，且该位置过度影响功能，则需进行手术矫正。手臂应置于旋前30至45度的位置。在单侧桡尺骨融合中，桡骨通常的理想位置是旋前10至20度。对于成年人，在决定前臂的旋转位置时应考虑患者的职业。我们通常更倾向于通过桡骨和尺骨的联合部位进行横向截骨的方法。在手术期间及术后立即仔细观察对肢体血管状况的影响很重要。
