桡骨杵臼截骨及尺骨头复位治疗MadeLung畸形.pdfVIP

主 垄查2IJIl7 12月第28卷第12期 Chin J Pediatr Surg，December 2007，Vo1．28，No．12 · 临 床 研 究 · 桡骨杵臼截骨及尺骨头复位治疗 MadeLung畸形 许瑞江 李浩宇 于向华 聂少波 【摘要】 目的 探讨桡骨杵臼截骨及尺骨头复位治疗MadeLung畸形的初步疗效。方法 2002~2006年间应用桡骨远端杵臼截骨及尺骨头复位治疗MadeLung畸形4例，均为女性，左侧 1例，右侧1例，双侧2例。术前腕关节疼痛，X线片 示桡骨远端关节面向掌侧倾斜75。～85。(平均 80。)。手术年龄12~13岁(平均12．5岁)。结果 术后随诊1～4年(平均2年)，腕关节疼痛全部消 失，腕关节外观及活动均得到改善。1例出现尺骨截骨部位延期愈合。结论 桡骨杵臼截骨及尺骨 头复位是治疗MadeLung畸形的有效方法之一。 【关键词】 手畸形，先天性；截骨术；腕关节 11le prelimhm~ results 0f dome osteotomy of the distal radius with reduction of the head of ulna for Madelungsdeformity XUR“ —jiang，LJHao-yu，yUXiang—hua，NIEShao-bo．Department0厂PP 一 atric Surgery，PLA General Hospital。Bei ing 10(}853，China [Abstract] Objective To review the preliminary results of dome osteotomy of the distal radius and reduction of the head of ulna for Madelungs deformity．Methods Four patients with Madelungs deformity were treated by dome osteotomy of the distal radius and reduction of the head of ulna from 20()2 to 2006．They were all girls．There were one left sided，one right—sided and two bilateral deformi— ties．All patients complained of arthralgia of the wrist preoperatively．Radiographs showed that the av— erage angle of palmaris inclination of the distal radius was 8()。(75。一85。)．The average age at the time O{surgery was 12．5 years(range：12 to 13 years)．Results At the 2 year(range：1 to 4 years)fol— low-up，ali patients were pain free．The wrist appearance and function were satisfactory．One ulna heal— ing was delayed．Condusions Conclusions Dome osteotomy of the distal radius and reduction of the head of ulna iS an effective treatment for MadelunKs deform ity． [Key wordsl Hand deformities，congenital；()steotomy；Carpal joints MadeLung畸形是一种很少见的先天性腕部畸 及尺骨头复位，术前X线片显示桡骨远端关节面向 形，由于桡骨远端骺板的尺侧生长紊乱造成下桡尺 掌侧倾斜75。～85。(平均8()。，图1A)，CT示下桡尺 关节脱位，从而导致腕关节疼痛及功能障碍。目前