CAJ | 학술논문

目的探讨成人创伤性Madelung样畸形合并掌、背侧成角的矫治方法及其疗效.方法分别以掌侧钢板或外固定支架结合植骨等技术治疗陈旧性桡骨远端骨折后合并背、掌侧成角的Madelung样畸形47例,比较研究手术前后掌倾角、尺偏角、桡骨短缩及关节活动范围等,初步评价其临床疗效. 结果经随访6～27个月(平均16个月),掌倾角、尺偏角、桡骨短缩、关节面塌陷及腕关节功能均获明显改善(P<0.05). 结论合并背侧成角的Madelung畸形,应首选掌侧入路、截骨矫形、植骨、钢板内固定;而对于合并掌侧成角者,背侧小切口截骨矫形、植骨、动力型外支架固定当为理想选择.
목적 탐토성인창상성Madelung양기형합병장、배측성각적교치방법급기료효.방법 분별이장측강판혹외고정지가결합식골등기술치료진구성뇨골원단골절후합병배、장측성각적Madelung양기형47례,비교연구수술전후장경각、척편각、뇨골단축급관절활동범위등,초보평개기림상료효. 결과 경수방6～27개월(평균16개월),장경각、척편각、뇨골단축、관절면탑함급완관절공능균획명현개선(P<0.05). 결론 합병배측성각적Madelung기형,응수선장측입로、절골교형、식골、강판내고정;이대우합병장측성각자,배측소절구절골교형、식골、동력형외지가고정당위이상선택.
Objective To explore surgical methods and their efficacy for post-traumatic Made-lung deformity complicated with dorsal or volar angulation in the adults. Methods Volar plate or exter-nal fixator, combined with the techniques osteotomy and bone grafting, were selected to treat adult pa-tients with post-traumatic Madelung deformity complicated with dorsal or volar angulation. The effects were preliminarily evaluated through comparing the volar tilting angle, ulnar inclination, radial shortening and the range of joint motion before and after the operation. Results All the patients were followed up for 6-27 months (mean 16 months). The volar tilting angle, radial inclination, radial shortening, range of joint motion of all patients were improved significantly (P<0.05). Conclusions For patients with Madelung deformity complicated with dorsal angulation, internal fixation of volar plate combined with volar osteotomy and bone grafting is recommended; while dynamic eternal fixator combined with combined with dorsal osteotomy and bone grafting is an ideal choice for patients with Madelung deformity complicated with volar angulation.