目的:为了研究radial球手的长期结果,关于尺骨生长,径向角度,和掌侧半脱位使用2阶段治疗方案。
方法:从1998年到2009年,对39个桡骨手(32例)进行了分散治疗,辐射,和双叶皮瓣。13例患者获得了长期随访(17手;平均12.6年,范围9-16年)。所有17只手都被分类为Bayne和Klug3或4级。
结果:分心的平均年龄为12个月(SD5.3)。辐射的平均年龄为14个月(SD5.8)。在最后的后续行动中,在单侧病例中,受累侧的尺骨平均长度为未受累对侧的69.3%。在4个双边病例中,平均尺骨长度为一组正常儿童尺骨长度的62%.后前视尺骨的横径为79%,在侧视图中,99%,在单侧病例中,对侧的半径。平均径向偏差从82°提高到8°,平均掌侧半脱位从20°提高到12°。然而,4只手复发性掌侧半脱位,需要翻修手术。
结论:这种治疗方法与径向角度校正的结果一致。掌侧半脱位,和长期随访中的尺骨生长。掌骨半脱位可能会导致需要修订。
方法:治疗IV。
To study the long-term results of radial club hand, regarding ulna growth, radial angulation, and volar subluxation using a 2-stage treatment protocol.
From 1998 to 2009, 39 radial club hands (32 patients) were treated with distraction,
radialization, and a bilobed flap. Long-term follow-up was available in 13 patients (17 hands; average 12.6 years, range 9-16 years). All 17 hands were classified as Bayne and Klug grade 3 or 4.
The average age at distraction was 12 months (SD 5.3). The average age at
radialization was 14 months (SD 5.8). At final follow-up, the average ulna length on the involved side was 69.3% of the uninvolved contralateral side in the unilateral cases. In the 4 bilateral cases, the average ulna length was 62% of the ulna length of a cohort of normal children. The transverse diameter of the ulna in the posteroanterior view was 79%, and in the lateral view 99%, of the radius on the contralateral side in the unilateral cases. The average radial deviation improved from 82° to 8° and the average volar subluxation improved from 20° to 12°. However, in 4 hands recurrent volar subluxation and required revision surgery.
This approach to treatment was associated with consistent results in the correction of the radial angulation, volar subluxation, and ulna growth in long-term follow-up. Volar subluxation may result in a requirement for revision.
Therapeutic IV.