METHODS: This study is case series research. We established 48 digital three-dimensional forearm bone models of 48 patients with congenital radioulnar synostosis classified as Cleary and Omer type 3. All the patients were treated at our institution from January 2010 to June 2016. In total, 10 independent deformities (the rotation angle of forearm; the internal rotation, radial, and dorsal angulation of radius and ulna; the relative length of osseous fusion at PRUJ; the relative dislocation distance of distal radioulnar joint; the relative area of proximal radial epiphysis) involved in the CRUS complex deformity were measured. Pearson correlation analysis for each deformity which was mentioned above was performed, and multivariate linear regression analysis was also performed with FR as the dependent variable and the other deformities as the influential factors.
RESULTS: The \"dorsal angle of radius\" (DAR, 21.69° ± 21.55°) had the strongest correlation with the FR (79.72° ± 40.39°), the Pearson correlation coefficient was 0.601 (p < 0.01), the internal rotation angle of the radius (IRAR, 82.69° ± 54.98°) had a moderate correlation with FR, the Pearson correlation coefficient was 0.552 (p < 0.01). A forearm deformity equation was established: FR = 35.896 + 0.271 DAR + 0.989 IRAR.
CONCLUSIONS: The dorsal angulation deformity of radius may be the most important deformity that effects the severity of CRUS and should be correct in the first place during reconstruction operation.
方法:本研究为案例系列研究。我们建立了48例分为Cleary和Omer3型的先天性桡骨滑膜炎患者的48个数字三维前臂骨模型。所有患者均于2010年1月至2016年6月在我院接受治疗。总的来说,10个独立畸形(前臂的旋转角度;内部旋转,径向,桡骨和尺骨的背侧角度;PRUJ处的骨融合的相对长度;桡尺远端关节的相对脱位距离;涉及CRUS复合体畸形的近端桡骨骨phy的相对面积)。对上述每种畸形进行Pearson相关分析,并以FR为因变量,其他畸形为影响因素进行多元线性回归分析。
结果:“半径的背角”(DAR,21.69°±21.55°)与FR(79.72°±40.39°)相关性最强,皮尔逊相关系数为0.601(p<0.01),半径的内部旋转角度(IRAR,82.69°±54.98°)与FR有中等相关性,Pearson相关系数为0.552(p<0.01)。建立前臂畸形方程:FR=35.896+0.271DAR+0.989IRAR。
结论:桡骨背角畸形可能是影响CRUS严重程度的最重要的畸形,在重建手术中应首先纠正。