改良Ilizarov技术治疗成人桡骨头前脱位

The improved Ilizarov technique in the treatment of adult anterior dislocation of the radial head

目的：探讨应用改良Ilizarov技术治疗成人桡骨头前脱位的疗效。方法对6例成人桡骨头前脱位，按设计将改良后的三组 Ilizarov 环安放在患肢前臂背侧，距尺骨鹰嘴5.0 cm处行尺骨横行截骨，然后沿其纵轴延长，达适宜长度后，再将尺骨向后成角延长，桡骨头即缓慢复位。结果术后平均随访8个月（3～10个月），桡骨头复位良好稳定；肘关节伸屈活动基本正常，前臂旋前达90＆#176;，旋后较术前有明显改善，平均55＆#176;；尺骨延长部位全部骨性愈合。其中1例出现个别钉道表浅感染，经处理痊愈。结论应用改良Ilizarov技术治疗成人桡骨头前脱位操作简单，创伤小，不干扰肱桡关节，改良环固定牢靠，复位桡骨头稳定而且肘关节伸屈和前臂旋转功能恢复满意，是临床值得推广的治疗方法。

Objective To investigate the clinical effect of the improved Ilizarov technique to treat adult anterior dislocation of the radial head. Methods 6 adult patients with anterior dislocation of the radial head were treated. According to the design, three groups of improved Ilizarov ring were placed in the dorsal side of forearm, transverse osteotomy of ulna at 5 cm from the olecranon was operated and then extended along its longitudinal axis, as a suitable length, the backward angular extension of ulnar was done, the slow reduction of radial head occurred. Results The mean follow-up time was 8 months （3~10 months）, the reduction of the radial head was good and stable; elbow flexion activities was basically normal, forearm pronation 90 ＆#176; , supination was better than that of pre operation, an average of 55 ＆#176;; bone healing was obtained at the ulnar lengthening site. Individual superficial pin tract infection occurred in 1 case, but cured by treatment. Conclusion The application of modified Ilizarov technique in the treatment of adult anterior dislocation of the radial head has the advantage of simple operation, less trauma, less humeroradial joint interference, firm fixation of improved ring, stability of the reducted radial head and satisfactory function recovery of elbow flexion and forearm rotation, it is a treatment method worthy of popularization in clinics.