PDF(Pubmed)
Abstract：
Few articles have reported on the treatment of Masada type 2 forearm deformities in hereditary multiple exostosis, possibly because of the high redislocation rate and other complications. This study precisely declares the use of modified ulnar lengthening by an Ilizarov external fixation with tumour excision for the treatment of Masada type 2 forearm deformities. 20 children with Masada type 2 forearm deformities were admitted for surgical treatment at our hospital from February 2014 to February 2021. There were 13 girls and 7 boys, ranging in age from 3.5 to 15 years (mean: 9 years) at the time of operation. We removed the prominent osteochondromas of the distal ulna and the proximal radius, positioned a classic Ilizarov external fixator on the forearm and then performed ulnar transverse one-third proximal diaphyseal subperiosteal osteotomy. We adopted modified ulnar lengthening postoperatively. The effects of surgical correction of deformity and functional improvement of the limb were assessed via regular follow-up and X-ray. The patients were followed up for 36 months, and the ulna was lengthened 26.99 mm on average; all radial heads remained relocated. The radiographic evaluations, including relative ulnar shortening, radial articular angle, and carpal slip, were improved. The functions of the elbow and forearm were all improved after surgery. Modified ulnar lengthening by an Ilizarov external fixation with tumour excision for the treatment of Masada type 2 forearm deformities in hereditary multiple exostoses has been proven to be an effective and reliable technique in the early stage.
摘要：
很少有文章报道过Masada2型前臂畸形在遗传性多发性外生体中的治疗，可能是因为再脱位率高和其他并发症。这项研究准确地宣布了通过Ilizarov外固定和肿瘤切除的改良尺骨延长术用于治疗Masada2型前臂畸形。2014年2月至2021年2月，20例Masada2型前臂畸形患儿在我院接受手术治疗。有13个女孩和7个男孩，手术时年龄在3.5至15岁之间（平均：9岁）。我们切除了尺骨远端和桡骨近端突出的骨软骨瘤，将经典的Ilizarov外固定器放置在前臂上，然后进行尺骨横向三分之一近端骨干骨膜下截骨术。术后采用改良尺骨延长术。通过定期随访和X射线评估手术矫正畸形和肢体功能改善的效果。随访36个月,尺骨平均延长26.99毫米；所有radial头仍搬迁。射线照相评估，包括尺骨相对缩短，桡骨关节角,和腕滑,改进了。术后肘关节和前臂功能均得到改善。通过Ilizarov外固定和肿瘤切除的改良尺骨延长术治疗遗传性多发性外生体中的Masada2型前臂畸形已被证明是早期有效且可靠的技术。
