马德隆畸形的X线分型和治疗方法的探讨

Investigation on X ray Classification and Treatment of Madelungs Abnormality.

研究马德隆畸形的Ｘ线分型及治疗方法的探讨。分析了自１９７７～１９９５年以来诊断为马德隆畸形４７例７３侧的临床资料，根据患者分型不同分别采取手法矫正、尺骨远端骨骺阻滞桡骨远端骨骺刺激、尺骨小头切除或尺骨短缩桡骨远端楔形截骨、尺骨短缩桡骨远端楔形截骨翻转加管形石膏外固定术。平均随访９年。疗效评定标准：根据术后症状、体征的改善程度分优、良、可、差４级。２１例术后疗效优良，占８４％。提出马德隆畸形的Ｘ线分型，依据此分型分别采取不同的治疗方法。

Objective:To study X ray classification and treatment of Madelungs abnormality.Methods:Clinical data of 73 wrists in 47 cases of Madelungs abnormality form 1997 to 1995 were analyzed(25 cases were followed up).According to classification of the patients,corresponding therapy was selected,including manual therapy,retardant of distal epiphysis of the ulna,stimulation of distal epiphysis of the radius,resection of the head of ulna or shortening of ulna and distal cuneiform osteotomy of radius,turnover and external fixation with plaster cast.Results:The follow up lasted for 9 years in average.Assessment of curative effect (excellent,good,fair and poor)was based on symptoms after operation and improvement of signs.After operation,21 cases were considered to be excellent and good,accounting for 84%.Conclusion:X ray grouping of Madelungs abnormality was proposed.Different treatment methods were adopted separately for corresponding type of the deformities and the result was good.