■探讨改良尺骨逐渐延长术治疗遗传性多发性骨软骨瘤(HMO)儿童MasadaIIb型前臂畸形的效果。
■从2015年5月至2020年10月,由HMO引起的MasadaIIb型前臂畸形的12名儿童在我们医院接受了改良的逐渐尺骨延长术。回顾性分析临床及影像学资料。临床评估包括腕关节屈伸,腕尺和桡骨偏差,前臂旋前和旋后,和肘部的运动范围。测量的射线照相参数包括径向关节角,腕滑,和相对尺骨缩短。
■12名患者的平均手术年龄(9名男性,3名女性)为8.5±2.7岁,平均随访31.5±5.7个月,平均尺骨延长为43.3±9.9mm。术前与末次随访的桡骨关节角度差异无统计学意义(从36.5°±9.2°到33.8°±5.1°,p>0.05)。然而,腕部滑脱(从61.3%±18.8%到33.8%±20.8%)和相对尺骨缩短(从5.8±3.5mm到-0.9±4.85mm)显着变化(p<0.05)。改良尺骨逐渐延长后的活动范围明显改善,包括腕关节屈曲(从38.3°±6.2°到55.8°±9.0°),腕部伸展(从45.0°±9.8°到61.7°±8.1°),腕部尺骨偏离(从41.3°±8.6°到29.6°±7.8°),腕部径向偏差(18.3°±6.2°至30.0°±5.6°),前臂旋前(从44.6°±7.2°到62.1°±8.6°),前臂旋光(从50.0°±7.1°到52.9°±6.6°),和肘部运动范围(从117.1°±10.1°到127.9°±5.4°)(所有p<0.05)。随访期间,针道感染1例,骨不连1例。
■改良的逐渐尺骨延长术可有效治疗由HMO引起的MasadaIIb型前臂畸形,并改善前臂功能。
UNASSIGNED: To investigate the effect of modified gradual ulnar lengthening in the treatment of Masada type IIb forearm deformity in children with hereditary multiple osteochondromas (HMO).
UNASSIGNED: From May 2015 to October 2020, 12 children with Masada type IIb forearm deformity caused by HMO underwent modified gradual ulnar lengthening in our hospital. Clinical and imaging data were retrospectively analyzed. Clinical evaluation included wrist flexion and extension, wrist ulnar and radial deviation, forearm pronation and supination, and elbow range of motion. The radiographic parameters measured included the radial articular angle, carpal slip, and relative ulnar shortening.
UNASSIGNED: The mean operative age of the 12 patients (9 male, 3 female) was 8.5 ± 2.7 years, the mean follow-up was 31.5 ± 5.7 months, and the mean ulnar lengthening was 43.3 ± 9.9 mm. There was no significant difference in the radial articular angle between the preoperative period and the last follow-up (from 36.5° ± 9.2° to 33.8° ± 5.1°, p > 0.05). However, significant changes were found in carpal slip (from 61.3% ± 18.8% to 33.8% ± 20.8%) and relative ulnar shortening (from 5.8 ± 3.5 mm to -0.9 ± 4.85 mm) (p < 0.05). The range of motion significantly improved after modified gradual ulnar lengthening, including wrist flexion (from 38.3° ± 6.2° to 55.8° ± 9.0°), wrist extension (from 45.0° ± 9.8° to 61.7° ± 8.1°), wrist ulnar deviation (from 41.3° ± 8.6° to 29.6° ± 7.8°), wrist radial deviation (from 18.3° ± 6.2° to 30.0° ± 5.6°), forearm pronation (from 44.6° ± 7.2° to 62.1° ± 8.6°), forearm supination (from 50.0° ± 7.1° to 52.9° ± 6.6°), and elbow range of motion (from 117.1° ± 10.1° to 127.9° ± 5.4°) (all p < 0.05). During follow-up, there was one case of needle tract infection and one case of bone nonunion.
UNASSIGNED: Modified gradual ulnar lengthening can effectively treat Masada type IIb forearm deformity caused by HMO and improve forearm function.