肱骨髁上楔形截骨矫正外伤性肘内翻

Supracondylar wedge shape osteotomy of the humerus with internal fixation for posttraumatic cubitus varus

目的 寻找简易手术及内固定方法矫正外伤性肘内翻。方法 采用外侧直切口 ,截骨之前将 2根克氏针经外侧髁插入至远侧截骨线 ;采用楔形不完全截骨 ,保留内侧骨皮质 ,沿截骨线钻数个小孔 ,然后去除三角形骨块 ,用手法折断内侧骨皮质 ;在外翻位加压 ,同时前臂旋后和肘关节屈曲位直到角度满意后将远端克氏针送入近侧截骨线至内侧骨皮质。术后用石膏托外固定患肢于屈肘 90°位l～l 5个月。结果 6 4例患者畸形均矫正并有平均 4 2°提携角。无神经损伤或感染等并发症。随访 1～ 5年 (平均 3 6年 ) ,无一例再次复发。结论 该技术操作简单 ,损伤小 ,手术并发症少 。

Objective To investigate the simple and easy osteotomy and internal fixation for post traumatic cubitus. Methods Before the osteotomy insert two preset Kirschners needles through the lateral condlye into the distal osteotomy line. Along the osteotomy line make a few eyehole drills and use wedge osteotomy to remove the triangular mass of bone, preserve the medial cortical. Break this medial cortical bone manually. Supinate and flex the elbow joint and meanwhile abduct the limb until a satisfactory angle and support with plaster slab at 90° flexion for 1～1 5 months. Results The deformity in 64 patients was corrected to within 4 2° of the contralateral elbow. There were no nerve palsies or infection. There was no evidence of recurrence of deformity through 1～5 years follow up (3 6 years on average). Conclusion This technique is of a few complications with minimal damage and better effect.