Abstract：
BACKGROUND: Tardy ulnar nerve palsy is a common late complication of traumatic cubitus valgus. At present, the treatment of tardy ulnar nerve palsy associated with traumatic cubitus valgus is still controversial, whether these two problems can be corrected safely and effectively in one operation is still unclear. To investigate the supracondylar shortening wedge rotary osteotomy combined with in situ tension release of the ulnar nerve in the treatment of tardy ulnar nerve palsy associated with traumatic cubitus valgus.
METHODS: Between 2012 and 2019, 16 patients who had traumatic cubitus valgus deformities with tardy ulnar nerve palsy were treated with simultaneous supracondylar shortening wedge rotary osteotomy and ulnar nerve in situ tension release. we compared a series of indicators of preoperative and postoperative follow-up for at least 24 months, (1) elbow range of motion; (2) the radiographic correction of the preoperative and postoperative humerus-elbow-wrist angles; (3) the static two-point discrimination and grip strength; and (4) the preoperative and postoperative DASH scores of upper limb function. The minimum follow-up was 24 months postoperative (mean, 33 months; range, 24 ~ 44 months).
RESULTS: The mean ROM was improved from 107 ° preoperatively to 122 ° postoperatively (P = 0.001). The mean preoperative elbow wrist angle was 24.6 °, and the mean postoperative humerus-elbow wrist angle was 12.1 ° (P < 0.001). The average grip strength and static two-point discrimination improved from 21 kgf and 8 mm to 28 kgf and 4.0 mm (P < 0.001 and P < 0.001, respectively). The ulnar nerve symptoms were improved in all patients except one. The mean HASH score improved from 29 to 16 (P < 0.001).
CONCLUSIONS: Supracondylar shortening wedge rotary osteotomy combined with in situ tension release of ulnar nerve is an effective method for the treatment of traumatic cubitus valgus with tardy ulnar nerve palsy, which restored the normal biomechanical characteristics of the affected limb and improved the elbow joint function.
METHODS: Between 2012 and 2019, 16 patients who had traumatic cubitus valgus deformities with tardy ulnar nerve palsy were treated with simultaneous supracondylar shortening wedge rotary osteotomy and ulnar nerve in situ tension release. we compared a series of indicators of preoperative and postoperative follow-up for at least 24 months, (1) elbow range of motion; (2) the radiographic correction of the preoperative and postoperative humerus-elbow-wrist angles; (3) the static two-point discrimination and grip strength; and (4) the preoperative and postoperative DASH scores of upper limb function. The minimum follow-up was 24 months postoperative (mean, 33 months; range, 24 ~ 44 months).
RESULTS: The mean ROM was improved from 107 ° preoperatively to 122 ° postoperatively (P = 0.001). The mean preoperative elbow wrist angle was 24.6 °, and the mean postoperative humerus-elbow wrist angle was 12.1 ° (P < 0.001). The average grip strength and static two-point discrimination improved from 21 kgf and 8 mm to 28 kgf and 4.0 mm (P < 0.001 and P < 0.001, respectively). The ulnar nerve symptoms were improved in all patients except one. The mean HASH score improved from 29 to 16 (P < 0.001).
CONCLUSIONS: Supracondylar shortening wedge rotary osteotomy combined with in situ tension release of ulnar nerve is an effective method for the treatment of traumatic cubitus valgus with tardy ulnar nerve palsy, which restored the normal biomechanical characteristics of the affected limb and improved the elbow joint function.
摘要：
背景：尺神经麻痹是外伤性肘外翻常见的晚期并发症。目前,与外伤性肘外翻相关的尺神经麻痹的治疗仍然存在争议，这两个问题能否在一次手术中安全有效地得到纠正仍不清楚。探讨髁上短缩楔形旋转截骨联合尺神经原位张力松解术治疗伴外伤性肘外翻的尺神经麻痹。
方法：2012年至2019年，对16例外伤性肘外翻畸形伴尺神经迟钝性麻痹患者同时行髁上缩短楔形旋转截骨术和尺神经原位张力松解术。我们比较了术前和术后随访至少24个月的一系列指标，（1）肘关节活动范围；（2）术前和术后肱骨-肘关节-腕关节角度的X线校正；（3）静态两点辨别和握力；（4）术前和术后上肢功能DASH评分。最低随访时间为术后24个月(平均，33个月；范围，24~44个月)。
结果：平均ROM从术前107°改善至术后122°（P=0.001）。术前平均肘关节角度为24.6°,术后肱骨-肘关节平均角度为12.1°(P<0.001)。平均握力和静态两点辨别从21kgf和8mm提高到28kgf和4.0mm（分别为P<0.001和P<0.001）。除一名患者外，所有患者的尺神经症状均得到改善。平均HASH评分从29分提高到16分(P<0.001)。
结论：髁上缩短楔形旋转截骨术联合尺神经原位张力松解术是治疗外伤性肘外翻合并尺神经麻痹的有效方法。恢复了患肢的正常生物力学特征，改善了肘关节功能。
方法：2012年至2019年，对16例外伤性肘外翻畸形伴尺神经迟钝性麻痹患者同时行髁上缩短楔形旋转截骨术和尺神经原位张力松解术。我们比较了术前和术后随访至少24个月的一系列指标，（1）肘关节活动范围；（2）术前和术后肱骨-肘关节-腕关节角度的X线校正；（3）静态两点辨别和握力；（4）术前和术后上肢功能DASH评分。最低随访时间为术后24个月(平均，33个月；范围，24~44个月)。
结果：平均ROM从术前107°改善至术后122°（P=0.001）。术前平均肘关节角度为24.6°,术后肱骨-肘关节平均角度为12.1°(P<0.001)。平均握力和静态两点辨别从21kgf和8mm提高到28kgf和4.0mm（分别为P<0.001和P<0.001）。除一名患者外，所有患者的尺神经症状均得到改善。平均HASH评分从29分提高到16分(P<0.001)。
结论：髁上缩短楔形旋转截骨术联合尺神经原位张力松解术是治疗外伤性肘外翻合并尺神经麻痹的有效方法。恢复了患肢的正常生物力学特征，改善了肘关节功能。
