目的:前臂畸形常见于遗传性多发性骨软骨瘤(HMO)。尺骨延长和骨软骨瘤切除术的结果一般是有利的,临床和影像学检查。本研究旨在评估临床,射线照相,和MasadaI型畸形患者前臂重建的功能结果(尺骨远端骨软骨瘤伴放射状弯曲,无桡骨头错位)。
方法:对接受MasadaI型前臂畸形手术重建的HMO患者进行了10年的回顾性研究。10例患者中的11例前臂接受了外固定器的逐渐尺骨延长。手术时的年龄为5至12岁。射线照相评估包括尺骨缩短,桡骨关节角,和腕滑.临床评估包括肘部和腕部的活动范围。用手臂残疾评估功能结果,肩膀,手问卷和简短表格36调查。
结果:平均随访37.5个月,尺骨缩短显著改善,桡骨关节角,和腕滑.术前手臂平均残疾,肩膀,手的24.2分提高到17.3分。在简短表格36调查的3项措施中观察到显著改善:总体健康,社会功能,和健康变化。
结论:与文献一致,在MasadaI型前臂畸形中,手术重建产生了良好的临床和影像学结果。在心理健康量表中观察到主要的功能改善。在没有桡骨头脱位的情况下,基线身体损伤是最小的,但是尽管随着治疗的改善,这不一定与临床相关.这项研究可以帮助外科医生和家庭为手术设定现实的目标和期望。在HMO中,前臂延长也可能有额外的长期益处,包括预防桡骨头脱位,改进的运动范围,和更好的宇宙,未来的研究可能有助于澄清。
方法:治疗性V
OBJECTIVE: Forearm deformity is common in hereditary multiple osteochondromas (HMO). The results of ulnar lengthening and osteochondroma excision are generally favorable, both clinically and radiographically. This study aimed to assess the clinical, radiographic, and functional results of forearm reconstruction in patients with Masada type I deformity (osteochondroma in the distal ulna with radial bowing, without radial head dislocation).
METHODS: A retrospective review was performed on patients with HMO who underwent surgical reconstruction for a Masada type I forearm deformity over a 10-year period. Eleven forearms in 10 patients underwent gradual ulnar lengthening with an external fixator. Age at the time of surgery was 5 to 12 years. Radiographic evaluation included ulnar shortening, radial articular angle, and carpal slip. Clinical evaluation included range of motion of the elbow and wrist. Functional outcomes were evaluated with the Disabilities of the Arm, Shoulder, and Hand questionnaire and the Short Form-36 survey.
RESULTS: At an average follow-up of 37.5 months, significant improvement was observed in ulnar shortening, the radial articular angle, and carpal slip. Preoperative average Disabilities of the Arm, Shoulder, and Hand score of 24.2 improved to 17.3. Significant improvement was observed in 3 measures of the Short Form-36 survey: general health, social functioning, and health change.
CONCLUSIONS: In agreement with the literature, surgical reconstruction yielded favorable clinical and radiographic results in Masada type I forearm deformities. The main functional improvement was observed in scales of mental health. The baseline physical impairment was minimal in the absence of radial head dislocation, but although it improved with treatment, it was not necessarily clinically relevant. This study can assist surgeons and families in setting realistic goals and expectations for surgery. There may also be additional long-term benefits to forearm lengthening in HMO, including prevention of radial head dislocation, improved range of motion, and better cosmesis, which future research may help to clarify.
METHODS: Therapeutic V.