Rotational osteotomy of forearm bones for treatment of congenital radioulnar synostosis in children.

IF 2.8 3区 医学 Q1 ORTHOPEDICS
Xiaolin Luo, Zhenbiao Li, Shengping Tang, Xinda Zheng, Xiujiang Yang, Yangjie Cai, Shijie Liao, Xiaofei Ding
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引用次数: 0

Abstract

Background: Congenital radioulnar synostosis (CRUS) is a rare upper limb deformity characterized by impaired rotational movement of the forearm. Rotational osteotomy is a commonly employed surgical procedure for treatment. This study aimed to analyze its surgical efficacy in treating CRUS in children.

Methods: 22 children (24 limbs) with CRUS from January 2010 to December 2023 were retrospectively collected. Rotational osteotomy of proximal ulna and distal radius was performed. Forearm function was evaluated using Failla scores and hygiene and self-care scores in Activities of daily Living score (ADL score). In addition, patients were further grouped and compared according to type of ulnar internal fixation and age at surgery.

Results: 22 patients (14 males, 8 females), with an average age of 6.0 years and an average follow-up time of 56 months. The mean pronation angle before surgery was 75.0 ± 11.3°, the mean postoperative pronation angle was 3.8 ± 7.1°, and the mean correction degree was 78.8 ± 12.9°. The average Failla scores were 5.6 ± 2.1 points before operation and 14.0 ± 1.0 points after operation. The average scores of hygiene and self-care scores were 19.0 ± 5.1 points before surgery and 36.0 ± 3.9 points after surgery. No child developed complications such as osteofascial compartment syndrome or infection. The correction angle in the plate fixation group was 86.8 ± 10.6°, while in the K-wires group was 72.0 ± 10.7°. The postoperative Failla scores in the older age group were 13.0 ± 1.1 points, and in the younger age group were 14.3 ± 0.8 points.

Conclusion: Rotational osteotomy of forearm bones is safe and effective in the treatment of CRUS in children. Ulnar plate fixation has better correction than K-wires. Furthermore, younger children have better surgical outcomes than older ones.

前臂骨旋转截骨术治疗儿童先天性尺桡关节闭锁。
背景:先天性尺桡关节闭锁(CRUS)是一种罕见的上肢畸形,其特征是前臂旋转运动受损。旋转截骨术是一种常用的手术治疗方法。本研究旨在分析其治疗儿童CRUS的手术效果。方法:回顾性收集2010年1月~ 2023年12月收治的22例CRUS患儿(24肢)。行尺骨近端和桡骨远端旋转截骨术。采用Failla评分和日常生活活动评分(ADL评分)中的卫生和自我保健评分评估前臂功能。此外,根据尺骨内固定类型和手术年龄对患者进行分组比较。结果:22例患者(男14例,女8例),平均年龄6.0岁,平均随访56个月。术前平均旋前角为75.0±11.3°,术后平均旋前角为3.8±7.1°,平均矫正度为78.8±12.9°。术前平均filla评分5.6±2.1分,术后平均filla评分14.0±1.0分。卫生和生活自理评分术前平均19.0±5.1分,术后平均36.0±3.9分。无患儿出现骨筋膜室综合征或感染等并发症。钢板固定组矫正角度为86.8±10.6°,k针组矫正角度为72.0±10.7°。老年组术后filla评分为13.0±1.1分,年轻组术后filla评分为14.3±0.8分。结论:前臂旋转截骨术治疗儿童小腿创伤安全有效。尺骨钢板固定比克氏针矫正效果好。此外,年龄较小的儿童比年龄较大的儿童手术效果更好。
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来源期刊
CiteScore
4.10
自引率
7.70%
发文量
494
审稿时长
>12 weeks
期刊介绍: Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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