CAJ | 학술논문

目的评价桡骨旋转截骨术及尺、桡骨双旋转截骨术在治疗大龄产瘫前臂旋前畸形后遗症的价值. 方法 2007年8月至2011年8月,对20例产瘫前臂旋前畸形后遗症患儿,施行桡骨单纯桡骨旋转截骨(5例)、尺、桡骨双旋转截骨(15例)等两种术式,并经术后6～54个月(平均25个月)的随访.本组前臂功能以旋前位角度和自觉功能的改善作为评价标准.结果本组15例行尺、桡骨双截骨患儿中14例功能及外观明显改善,1例出现旋后畸形；5例行单纯桡骨旋前截骨者,术后3例功能及外观均获得改善,随访6个月、8个月后,其中合并桡骨小头脱位2例因疗效不佳行尺、桡骨双截骨,本组20例患者未出现骨不连.结论单纯桡骨旋转截骨矫形手术在产瘫前臂旋前畸形后遗症无桡骨小头脱位的治疗中具有一定的应用价值,尺、桡骨双截骨术在前臂旋前畸形合并桡骨小头脱位后遗症中疗效更优.
목적 평개뇨골선전절골술급척、뇨골쌍선전절골술재치료대령산탄전비선전기형후유증적개치. 방법 2007년8월지2011년8월,대20례산탄전비선전기형후유증환인,시행뇨골단순뇨골선전절골(5례)、척、뇨골쌍선전절골(15례)등량충술식,병경술후6～54개월(평균25개월)적수방.본조전비공능이선전위각도화자각공능적개선작위평개표준.결과 본조15례행척、뇨골쌍절골환인중14례공능급외관명현개선,1례출현선후기형；5례행단순뇨골선전절골자,술후3례공능급외관균획득개선,수방6개월、8개월후,기중합병뇨골소두탈위2례인료효불가행척、뇨골쌍절골,본조20례환자미출현골불련.결론 단순뇨골선전절골교형수술재산탄전비선전기형후유증무뇨골소두탈위적치료중구유일정적응용개치,척、뇨골쌍절골술재전비선전기형합병뇨골소두탈위후유증중료효경우.
Objective To evaluate the radial rotation osteotomy and ulnadouble rotation osteotomy obstetric brachial plexus injury (obstetric brachial plexus palsy) forearm pronation deformity sequelae value.Methods From August 2007 to August 2011, twenty cases of obstetric brachial plexus palsy sequelae in children with forearm pronation deformity, the implementation of a simple radial rotating radial osteotomy (5cases),double-rotation radius and ulna osteotomy (15 cases) and two surgical type,and by 6 to 54 months after surgery (mean 25 months) follow-up.The groupfunctions to forearm pronation angle and conscious function improvement as the evaluation criteria. Results The 15 cases of radius and ulna osteotomy in children with dual function and appearance in 14 cases significandy improved,one case of supination deformity;five underwent simple radial pronation osteotomy,three patients had improved function and appearance,followed up for 6 months, eight months after the merger which radial head dislocation in 2 cases due to poor efficacy of dual-line radius and ulna osteotomy, twenty patients in this group did not appear nonunion.Conclusion Simple radial rotation osteotomy surgery in obstetric brachial plexus palsy forearm pronation deformity complications without radial head dislocation has some value, radius and ulna double osteotomy in forearm pronation deformity with radial head dislocation aftermath of the effect is more excellent.