| 尺骨干骺端续连症不同手术方法的疗效观察 |
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Received:July 20, 2020
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| 作者 | Author | 单位 | Unit | E-Mail |
| 吕秉乐 |
LYU Bing-le |
洛阳正骨医院 河南省骨科医院骨病矫形科, 河南 郑州 450046 |
Department of Bone Disease & Orthopedics, Henan Luoyang Orthopaedic Hospital, Orthopaedic Hospital of Henan Province, Zhengzhou 450046, Henan, China |
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| 田亚敏 |
TIAN Ya-min |
洛阳正骨医院 河南省骨科医院骨病矫形科, 河南 郑州 450046 |
Department of Bone Disease & Orthopedics, Henan Luoyang Orthopaedic Hospital, Orthopaedic Hospital of Henan Province, Zhengzhou 450046, Henan, China |
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| 葛立业 |
GE Li-ye |
洛阳正骨医院 河南省骨科医院骨病矫形科, 河南 郑州 450046 |
Department of Bone Disease & Orthopedics, Henan Luoyang Orthopaedic Hospital, Orthopaedic Hospital of Henan Province, Zhengzhou 450046, Henan, China |
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| 许京华 |
XU Jing-hua |
洛阳正骨医院 河南省骨科医院骨病矫形科, 河南 郑州 450046 |
Department of Bone Disease & Orthopedics, Henan Luoyang Orthopaedic Hospital, Orthopaedic Hospital of Henan Province, Zhengzhou 450046, Henan, China |
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| 李东升 |
LI Dong-sheng |
洛阳正骨医院 河南省骨科医院骨病矫形科, 河南 郑州 450046 |
Department of Bone Disease & Orthopedics, Henan Luoyang Orthopaedic Hospital, Orthopaedic Hospital of Henan Province, Zhengzhou 450046, Henan, China |
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| 滕军燕 |
TENG Jun-yan |
洛阳正骨医院 河南省骨科医院骨病矫形科, 河南 郑州 450046 |
Department of Bone Disease & Orthopedics, Henan Luoyang Orthopaedic Hospital, Orthopaedic Hospital of Henan Province, Zhengzhou 450046, Henan, China |
Tengjy1981@126.com |
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| 期刊信息：《中国骨伤》2021年34卷，第7期，第636-640页 |
| DOI：10.12200/j.issn.1003-0034.2021.07.009 |
| 基金项目:河南省中医药科学研究专项（编号：2015ZY01002） |
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目的：探讨尺骨骨软骨瘤切除、尺骨微创截骨、外固定尺骨延长术治疗尺骨干骺端续连症前臂畸形治疗效果和安全性。
方法：自2005年8月至2013年12月，20例尺骨干骺端续连症患者，男15例，女5例；年龄7~13（10.00±2.34）岁；病程6~11（8.10±1.52）个月；临床表现为患侧前臂短缩并向尺侧弯曲畸形。采用尺骨骨软骨瘤切除、尺骨微创截骨、外固定尺骨延长术治疗，术后评估包括评估疼痛、日常生活活动、外观矫形效果及腕关节、肘关节和前臂的运动范围，放射学评估包括尺骨长度、桡骨关节面倾斜角和腕部骨骺生长情况。
结果：所有患者术后伤口愈合，未出现感染，与并发症相关的惟一术式是尺骨延长，包括1例骨不连、2例尺骨延长骨痂骨折、1例暂时性的桡神经麻痹。所有患者获得随访4~7.5（6.03±1.33）年。所有病例腕关节桡偏尺偏活动度数、前臂旋前旋后度数变化差异有统计学意义（P<0.05），放射学评估参数（尺骨方差，桡骨关节角，腕骨滑动）得到了改善且差异具有统计学意义（P<0.05），末次随访时改良Green和O'Brien腕关节功能评分与术前比较差异有统计学意义（P<0.05），腕关节的临床疗效与术前比较差异有统计学意义（P<0.05），末次随访Mayo肘关节功能评分与术前比较差异有统计学意义（P<0.05），肘关节的临床疗效与术前比较差异有统计学意义（P<0.05）。
结论：尺骨骨延长对阻止远期畸形的进展无益，单纯的尺骨远端骨软骨瘤切除术有利于阻止畸形的发展，腕关节和前臂旋转活动受限及对外观的改善有强烈的要求的患者可积极进行手术治疗。 |
| [关键词]:干骺端 尺骨 骨软骨瘤 前臂 畸形 外科手术 |
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| Clinical observation of different surgical methods for metaphyseal sequelae of ulna |
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Abstract:
Objective: To investigate the effect and safety of ulnar osteochondroma resection,ulnar minimally invasive osteotomy,external fixation and ulnar lengthening in the treatment of forearm deformity of metaphyseal extension of ulna.
Methods: From August 2005 to December 2013,there were 20 cases of ulnar metaphyseal sequelae,including 15 males and 5 females,aged from 7 to 13(10.00±2.34) years,the course of disease ranged for 6 to 11(8.10±1.52) months. The clinical manifestations were shortening of the affected forearm and bending to the ulnar side. The postoperative evaluation included pain,activities of daily living,orthopedic effect and the range of motion of wrist,elbow and forearm. The radiological evaluation included ulnar length,radial joint inclination angle and wrist epiphysis growth.
Results: All patients healed without infection. The only operation related to complications was ulnar lengthening,including 1 case of nonunion,2 cases of ulnar lengthening callus fracture and 1 case of temporary radial nerve palsy. All patients were followed up for 4 to 7.5 years,with an average of (6.03±1.33) years. There were statistically significant differences in changes of wrist radial deviation,ulnar deviation,forearm pronation and supination in all cases(P<0.05). Radiological evaluation parameters (ulnar variance,radial joint angle,wrist slip) were improved,and the differences were statistically significant(P<0.05). The modified Green and O'Brien wrist function scores at the last follow-up were significantly different from those before operation(P<0.05). The clinical effect of wrist joint was significantly different from that before operation (P<0.05). The Mayo elbow function score at the latest follow-up was significantly different from that before operation (P<0.05). The clinical effect of elbow joint was significantly different from that before operation(P<0.05).
Conclusion: Ulnar lengthening is not beneficial to prevent the development of long-term deformity. Simple resection of osteochondroma of distal ulna is beneficial to prevent the development of deformity. Patients with limited rotation of wrist joint and forearm and strong demand for improvement of appearance can be actively treated. |
| KEYWORDS:Metaphyseal Ulnar Osteochondroma Forearm Deformity Surgical operative,procedures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吕秉乐,田亚敏,葛立业,许京华,李东升,滕军燕.尺骨干骺端续连症不同手术方法的疗效观察[J].中国骨伤,2021,34(7):636~640 |
| 英文格式: | LYU Bing-le,TIAN Ya-min,GE Li-ye,XU Jing-hua,LI Dong-sheng,TENG Jun-yan.Clinical observation of different surgical methods for metaphyseal sequelae of ulna[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(7):636~640 |
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