Increasing Severity of Radial Longitudinal Deficiency Correlates With the Degree of Proximal Ulnar Hypoplasia

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2025-09-01 DOI:10.1016/j.jhsa.2024.04.014

Felicity G. Fishman MD, MJ , Alicia M. January PhD

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引用次数: 0

Abstract

Purpose

Classification systems and treatment for children with radial longitudinal deficiency are classically focused on the hand and wrist. However, the elbow can affect the function of these patients secondary to stiffness or instability. The objective of this study was to determine if a correlation exists between severity of radial longitudinal deficiency (RLD) and degree of proximal ulnar hypoplasia.

Methods

A single-institution retrospective review was performed at a pediatric hospital. One hundred elbows were identified in 72 patients who met the inclusion criteria. Measurements such as the coronoid height, olecranon coronoid angle (OCA), and the anterior coverage index were obtained from lateral radiographs of children with RLD. Ten elbows had posterior subluxation of the ulnohumeral joint radiographically. Eleven patients had thrombocytopenia absent radius (TAR) syndrome.

Results

There was a significant mean difference for OCA between RLD types. Type 4 RLD (mean [M] = 17.9; standard deviation [SD] = 11.3) had a significantly lower OCA than type 0 (M = 26.4; SD = 5.9) and type 1 (M = 31.0; SD = 5.0). A subanalysis of the 58 elbows with type 4 RLD demonstrated that those with TAR (n = 11) had significantly higher anterior coverage index total scores (M = 1.7; SD = 0.3) than those with type 4 without TAR (M = 1.5; SD = 0.2).

Conclusions

The degree of proximal ulnar hypoplasia is correlated with increasing severity of RLD, with significantly lower OCA and coronoid height observed in the elbow radiographs of patients with type 4 RLD compared with type 0 and type 1. Children with TAR have less proximal ulnar dysplasia and higher anterior coverage index than children with type 4 RLD without associated TAR.

Type of study/level of evidence

Prognostic IV.

查看原文本刊更多论文

桡骨纵向缺损的严重程度与近端尺骨发育不全的程度相关。

目的：桡骨纵向缺损儿童的分类系统和治疗方法通常侧重于手部和腕部。然而，肘部也会因僵硬或不稳定而影响这些患者的功能。本研究旨在确定桡骨纵向缺损（RLD）的严重程度与尺骨近端发育不良的程度之间是否存在相关性：方法：在一家儿科医院进行了一次单一机构的回顾性审查。方法：在一家儿科医院进行了一项单一机构的回顾性研究，对符合纳入标准的 72 名患者的 100 个肘部进行了鉴定。从RLD患儿的侧位X光片上获得了冠状面高度、肘冠状角（OCA）和前覆盖指数等测量值。有 10 名肘部患者的尺肱骨关节在影像学上出现后脱位。11名患者患有桡骨缺失血小板减少综合征（TAR）：RLD类型之间的OCA平均值差异很大。4型RLD（平均值[M] = 17.9；标准差[SD] = 11.3）的OCA明显低于0型（平均值[M] = 26.4；标准差[SD] = 5.9）和1型（平均值[M] = 31.0；标准差[SD] = 5.0）。对58个患有4型RLD的肘关节进行的子分析表明，患有TAR的肘关节（n = 11）的前覆盖指数总分（M = 1.7; SD = 0.3）明显高于未患有TAR的4型肘关节（M = 1.5; SD = 0.2）：结论：尺骨近端发育不良的程度与RLD严重程度的增加有关，在4型RLD患者的肘部X光片中观察到的OCA和冠状面高度明显低于0型和1型。与未伴有TAR的4型RLD患儿相比，伴有TAR的患儿尺骨近端发育不良程度较轻，前覆盖指数较高：预后IV。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.