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Abstract：
OBJECTIVE: The deformity of congenital radioulnar synostosis is quite complicated and difficult. This study aims to find out the related factors of the \"forearm rotation angle\" (FR) which relate to the severity of congenital radioulnar synostosis (CRUS), and try to quantify the internal relations of each deformity and help to understand the reconstruction method in surgery treatment of this disease.
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.
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.
摘要：
目的：先天性桡尺神经滑膜畸形复杂困难。本研究旨在找出“前臂旋转角度”（FR）与先天性尺桡骨滑膜炎（CRUS）严重程度相关的相关因素，并尝试量化各畸形的内在联系,帮助了解本病手术治疗中的重建方法。
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。
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。
