目标:迄今为止,描述了不同的矫正截骨术治疗桡骨远端关节外畸形畸形的方法。通过这项研究,我们介绍了一系列使用掌侧钢板固定术治疗掌侧和背侧关节外畸形的矫正截骨术,旨在评估通过掌侧钢板稳定在这两种类型的关节外畸形中进行矫正截骨术的有效性。
方法:2008年8月至2017年5月,所有诊断为关节外畸形愈合的患者均纳入研究。扩展的掌侧Orbay方法和两种类型的专用掌侧锁定板(MedartisAG,瑞士和Acumed,希尔斯伯勒,OR)被使用。评估了临床和放射学参数。进行DASH和PRWE评分以及VAS量表问卷。通过统计评价对结果进行分析。
结果:对19例诊断为关节外畸形愈合的患者进行回顾性分析。9人患有掌侧畸形(A组),而其他10例患有背侧型畸形(B组)。活动范围(aROM),射线照相参数,两组的握力和捏力均有统计学改善,除了两组的径向偏差,A组尺骨偏离,和径向倾斜B组的握力和捏力值略好于A组。DASH,PRWE评分和VAS量表均有显著改善。
结论:掌侧固定矫正截骨术是治疗关节外背侧和掌角畸形畸形的有效技术。两种类型的畸形都存在统计学上显著的益处,掌侧畸形组的结果更好。
To date, different technique of corrective osteotomy for the treatment of distal radius extra-articular malunions are described. With this study, we present a
case series of corrective osteotomy using volar plate fixation to treat volar and dorsal extra-articular malunions aiming to evaluate the effectiveness of corrective osteotomies through volar plate stabilization in these two types of extra-articular malunions.
Between August 2008 and May 2017 all patients diagnosed with extra-articular malunion were included in the study. An extended volar Orbay approach and two types of dedicated volar locking plate (Medartis AG, Switzerland and Acumed, Hillsboro,OR) were used. Clinical and radiological parameters were evaluated. The DASH and PRWE scores and the VAS scale questionnaires were administered. The results were analyzed through statistical evaluations.
A retrospective analysis of 19 patients diagnosed with extra-articular malunion was carried out. Nine had a volar type deformity (group A), while the other 10 had a dorsal type deformity (group B). The active range of motion (aROM), radiographic parameters, grip strength and pinches in both groups were statistically improved, except for radial deviation in both groups, ulnar deviation in group A, and radial inclination in group B. The grip strength and pinches values were slightly better in group A. DASH, PRWE scores and VAS scale showed a significant improvement.
Corrective osteotomy through volar fixation is an effective technique to treat both extra-articular dorsally and volarly angulated malunions. Statistically significant benefits are present in both types of deformities, with better outcomes in the group of volar deformities.