Abstract：
OBJECTIVE: Classification systems and treatment for children with radial longitudinal deficiency are classically focused on the hand and wrist. However, the elbow can affect the function of these patients secondary to stiffness or instability. The objective of this study was to determine if a correlation exists between severity of radial longitudinal deficiency (RLD) and degree of proximal ulnar hypoplasia.
METHODS: A single-institution retrospective review was performed at a pediatric hospital. One hundred elbows were identified in 72 patients who met the inclusion criteria. Measurements such as the coronoid height, olecranon coronoid angle (OCA), and the anterior coverage index were obtained from lateral radiographs of children with RLD. Ten elbows had posterior subluxation of the ulnohumeral joint radiographically. Eleven patients had thrombocytopenia absent radius (TAR) syndrome.
RESULTS: There was a significant mean difference for OCA between RLD types. Type 4 RLD (mean [M] = 17.9; standard deviation [SD] = 11.3) had a significantly lower OCA than type 0 (M = 26.4; SD = 5.9) and type 1 (M = 31.0; SD = 5.0). A subanalysis of the 58 elbows with type 4 RLD demonstrated that those with TAR (n = 11) had significantly higher anterior coverage index total scores (M = 1.7; SD = 0.3) than those with type 4 without TAR (M = 1.5; SD = 0.2).
CONCLUSIONS: The degree of proximal ulnar hypoplasia is correlated with increasing severity of RLD, with significantly lower OCA and coronoid height observed in the elbow radiographs of patients with type 4 RLD compared with type 0 and type 1. Children with TAR have less proximal ulnar dysplasia and higher anterior coverage index than children with type 4 RLD without associated TAR.
METHODS: Prognostic IV.
METHODS: A single-institution retrospective review was performed at a pediatric hospital. One hundred elbows were identified in 72 patients who met the inclusion criteria. Measurements such as the coronoid height, olecranon coronoid angle (OCA), and the anterior coverage index were obtained from lateral radiographs of children with RLD. Ten elbows had posterior subluxation of the ulnohumeral joint radiographically. Eleven patients had thrombocytopenia absent radius (TAR) syndrome.
RESULTS: There was a significant mean difference for OCA between RLD types. Type 4 RLD (mean [M] = 17.9; standard deviation [SD] = 11.3) had a significantly lower OCA than type 0 (M = 26.4; SD = 5.9) and type 1 (M = 31.0; SD = 5.0). A subanalysis of the 58 elbows with type 4 RLD demonstrated that those with TAR (n = 11) had significantly higher anterior coverage index total scores (M = 1.7; SD = 0.3) than those with type 4 without TAR (M = 1.5; SD = 0.2).
CONCLUSIONS: The degree of proximal ulnar hypoplasia is correlated with increasing severity of RLD, with significantly lower OCA and coronoid height observed in the elbow radiographs of patients with type 4 RLD compared with type 0 and type 1. Children with TAR have less proximal ulnar dysplasia and higher anterior coverage index than children with type 4 RLD without associated TAR.
METHODS: Prognostic IV.
摘要：
目的：放射状纵向缺陷儿童的分类系统和治疗通常集中在手和手腕上。然而,肘部可以影响这些患者继发的僵硬或不稳定的功能。这项研究的目的是确定radial骨纵向缺陷（RLD）的严重程度与尺骨近端发育不全的程度之间是否存在相关性。
方法：在儿科医院进行了单机构回顾性研究。在72名符合纳入标准的患者中确定了100个肘部。诸如冠状高度之类的测量，鹰嘴冠状角（OCA），前覆盖指数是从RLD儿童的侧位X线片获得的。十个肘部在影像学上显示了尺肱骨关节的后半脱位。11例患者出现血小板减少症（TAR）综合征。
结果：RLD类型之间的OCA存在显着差异。4型RLD（平均值[M]=17.9；标准偏差[SD]=11.3）的OCA明显低于0型（M=26.4；SD=5.9）和1型（M=31.0；SD=5.0）。对58个具有4型RLD的肘部的亚分析表明，具有TAR（n=11）的肘部的前覆盖指数总分（M=1.7；SD=0.3）明显高于没有TAR的4型肘部（M=1.5；SD=0.2）。
结论：尺骨近端发育不全的程度与RLD的严重程度有关，与0型和1型相比，在4型RLD患者的肘部X线片中观察到的OCA和冠状突高度显着降低。与没有相关TAR的4型RLD儿童相比，TAR儿童的近端尺骨发育不良较少，前牙覆盖指数较高。
方法：预后IV.
方法：在儿科医院进行了单机构回顾性研究。在72名符合纳入标准的患者中确定了100个肘部。诸如冠状高度之类的测量，鹰嘴冠状角（OCA），前覆盖指数是从RLD儿童的侧位X线片获得的。十个肘部在影像学上显示了尺肱骨关节的后半脱位。11例患者出现血小板减少症（TAR）综合征。
结果：RLD类型之间的OCA存在显着差异。4型RLD（平均值[M]=17.9；标准偏差[SD]=11.3）的OCA明显低于0型（M=26.4；SD=5.9）和1型（M=31.0；SD=5.0）。对58个具有4型RLD的肘部的亚分析表明，具有TAR（n=11）的肘部的前覆盖指数总分（M=1.7；SD=0.3）明显高于没有TAR的4型肘部（M=1.5；SD=0.2）。
结论：尺骨近端发育不全的程度与RLD的严重程度有关，与0型和1型相比，在4型RLD患者的肘部X线片中观察到的OCA和冠状突高度显着降低。与没有相关TAR的4型RLD儿童相比，TAR儿童的近端尺骨发育不良较少，前牙覆盖指数较高。
方法：预后IV.
