Abstract：
OBJECTIVE: In this study, we present a specified hinge positioning method to achieve satisfying and steerable lengthening and angulation to correct forearm multiple hereditary exostoses (MHE) combined with severe radiocapitellar joint dislocation using Ilizarov ring fixators.
METHODS: Between January 2014 and December 2018, a total of 30 forearms of 23 patients (11 males, 12 females; mean age: 18.3±6.8 years; range, 8 to 35 years) who suffered from type IIa (n=2) or IIb (n=28) MHE with severe radiocapitellar joint luxation were retrospectively analyzed. All patients were treated with Ilizarov external fixators with our specified hinge positioning method. Range of motion of the elbow, forearm and wrist and Visual Analog Scale (VAS), as well as Disabilities of Arm, Shoulder, and Hand (DASH) score, and radiological parameters, including radial articular angle (RAA), ulnar variance (UV) and carpi slip (CS), were recorded preoperatively and at final follow-up and were compared.
RESULTS: Clinical and radiological outcomes were evaluated. Range of motion of the elbow, forearm and wrist, VAS, DASH and radiological features, including RAA, CS, and UV were significantly improved, except for range of motion of the forearm supination. Temporary nail track infection was seen in two of the forearms and was controlled with oral antibiotics. None of the patients developed radial head dislocation again.
CONCLUSIONS: Clinical and radiological outcomes of this novel hinge positioning method are satisfactory in treating MHE with severe radial head dislocation, and this method can be an alternative treatment for MHE by setting a milestone for accurate radiocapitellar joint reduction.
METHODS: Between January 2014 and December 2018, a total of 30 forearms of 23 patients (11 males, 12 females; mean age: 18.3±6.8 years; range, 8 to 35 years) who suffered from type IIa (n=2) or IIb (n=28) MHE with severe radiocapitellar joint luxation were retrospectively analyzed. All patients were treated with Ilizarov external fixators with our specified hinge positioning method. Range of motion of the elbow, forearm and wrist and Visual Analog Scale (VAS), as well as Disabilities of Arm, Shoulder, and Hand (DASH) score, and radiological parameters, including radial articular angle (RAA), ulnar variance (UV) and carpi slip (CS), were recorded preoperatively and at final follow-up and were compared.
RESULTS: Clinical and radiological outcomes were evaluated. Range of motion of the elbow, forearm and wrist, VAS, DASH and radiological features, including RAA, CS, and UV were significantly improved, except for range of motion of the forearm supination. Temporary nail track infection was seen in two of the forearms and was controlled with oral antibiotics. None of the patients developed radial head dislocation again.
CONCLUSIONS: Clinical and radiological outcomes of this novel hinge positioning method are satisfactory in treating MHE with severe radial head dislocation, and this method can be an alternative treatment for MHE by setting a milestone for accurate radiocapitellar joint reduction.
摘要：
目的：在本研究中，我们提出了一种指定的铰链定位方法，以使用Ilizarov环固定器实现令人满意的可操纵的延长和成角，以纠正前臂多发性遗传性外生性骨瘤（MHE）和严重的radiocitlar关节脱位。
方法：在2014年1月至2018年12月之间，共有23名患者（11名男性，12名女性；平均年龄：18.3±6.8岁；范围，回顾性分析了8至35岁）患有IIa型（n=2）或IIb型（n=28）MHE并伴有严重的放射性腕关节脱位的患者。所有患者均采用我们指定的铰链定位方法使用Ilizarov外固定器进行治疗。肘部的运动范围，前臂和手腕和视觉模拟量表(VAS)，以及手臂的残疾，肩膀,和手（DASH）得分，和放射学参数，包括径向关节角（RAA），尺骨方差(UV)和腕滑(CS)，在术前和最终随访时进行记录并进行比较。
结果：评估了临床和放射学结果。肘部的运动范围，前臂和手腕,VAS,DASH和放射学特征，包括RAA,CS,和紫外线显著改善，除了前臂旋后的活动范围。在两个前臂中发现了临时的指甲道感染，并使用口服抗生素进行了控制。没有患者再次发生桡骨头脱位。
结论：这种新型铰链定位方法治疗MHE伴严重桡骨头脱位的临床和放射学结果令人满意，并且该方法可以通过为精确的radiocitlar关节复位设置里程碑而成为MHE的替代治疗方法。
方法：在2014年1月至2018年12月之间，共有23名患者（11名男性，12名女性；平均年龄：18.3±6.8岁；范围，回顾性分析了8至35岁）患有IIa型（n=2）或IIb型（n=28）MHE并伴有严重的放射性腕关节脱位的患者。所有患者均采用我们指定的铰链定位方法使用Ilizarov外固定器进行治疗。肘部的运动范围，前臂和手腕和视觉模拟量表(VAS)，以及手臂的残疾，肩膀,和手（DASH）得分，和放射学参数，包括径向关节角（RAA），尺骨方差(UV)和腕滑(CS)，在术前和最终随访时进行记录并进行比较。
结果：评估了临床和放射学结果。肘部的运动范围，前臂和手腕,VAS,DASH和放射学特征，包括RAA,CS,和紫外线显著改善，除了前臂旋后的活动范围。在两个前臂中发现了临时的指甲道感染，并使用口服抗生素进行了控制。没有患者再次发生桡骨头脱位。
结论：这种新型铰链定位方法治疗MHE伴严重桡骨头脱位的临床和放射学结果令人满意，并且该方法可以通过为精确的radiocitlar关节复位设置里程碑而成为MHE的替代治疗方法。
