Smith A A, Greene T L
Division of Plastic Surgery, Case Western Reserve School of Medicine, Cleveland, OH 44109-1998, USA.
J Hand Surg Am. 1995 May;20(3):420-4. doi: 10.1016/S0363-5023(05)80099-1.
Four patients (five limbs) were treated with preliminary soft tissue distraction using an Orthofix external distractor. The patient's ages ranged from 6 months to 14 years. Forearm deficiencies treated included partial absence of the radius (one patient), radial aplasia (two patients, three limbs), and partial absence of the ulna (one patient). Soft tissue distraction (mean, 55 days) was continued in radial deficiency until the hand could be passively centralized without residual radial deviation, allowing centralization to be accomplished through a single mid-dorsal incision. Mean measurement of distraction for the radial deficiencies was 1 cm. In the ulnar deficiency, soft tissue distraction was carried out until the cut radius was distal to the partially absent ulna (98 days) allowing for the creation of a one-bone forearm using the entire radius. Distraction (1 mm/day) was done by the children's parents with no distractor removed because of patient intolerance. All radial deficiency limbs remained centralized at a mean followup period of 14 months.
4例患者（5条肢体）采用Orthofix外固定牵开器进行初步软组织牵张治疗。患者年龄从6个月至14岁不等。治疗的前臂缺损包括桡骨部分缺如（1例患者）、桡骨发育不全（2例患者，3条肢体）以及尺骨部分缺如（1例患者）。对于桡骨缺损，持续进行软组织牵张（平均55天），直至手部能够被动中心化且无残余桡偏，从而可通过单一的背侧正中切口完成中心化。桡骨缺损的平均牵张量为1厘米。对于尺骨缺损，进行软组织牵张直至切断的桡骨位于部分缺如的尺骨远端（98天），以便利用整个桡骨构建单骨前臂。牵张（1毫米/天）由患儿家长完成，未因患者不耐受而移除牵开器。所有桡骨缺损肢体在平均14个月的随访期内均保持中心化。
