骨痂延长术治疗尺骨远端遗传性多发性骨软骨瘤致前臂畸形的疗效分析

Effect analysis of callus lengthening in the treatment of ulna distal hereditary multiple exostosis induced forearm deformity

目的探讨骨痂延长术治疗尺骨远端遗传性多发性骨软骨瘤（HME）致前臂畸形的临床效果。方法 选取2013年4月-2014年4月三峡大学人民医院诊治的19例尺骨远端HME致前臂畸形患者,入选患者均采用骨痂延长术治疗,手术前后患者均使用X线进行评定,观察入选患者关节功能、相对尺骨缩短长度、桡骨关节面尺倾角、腕骨偏差率、Krimmer腕关节功能等指标。结果 患者术后相对尺骨缩短长度、桡骨关节面尺倾角、腕骨偏差率、屈肘、伸肘、前臂旋前等功能均较术前明显改善,差异有统计学意义（P〈0.05）。患者术后屈腕、伸腕及桡偏均显著大于术前,差异有统计学意义（P〈0.05）;患者手术前后尺偏比较,差异无统计学意义（P〉0.05）。患者术后Krimmer腕关节功能评分评价符合率为100.0%,高于术前的78.9%,差异有统计学意义（P〈0.05）。结论 尺骨远端HME致前臂畸形患者采用骨痂延长术治疗的效果理想,值得推广应用。

Objective To investigate clinical effect of callus lengthening in the treatment of ulna distal hereditary mul- tiple exostosis （HME） induced forearm deformity. Methods 19 patients with ulna distal HME induced forearm deformity in People＇s Hospital of Three Gorges University from April 2013 to April 2014 were selected. The patients were treated with callus lengthening treatment, before and after operation, the patients were evaluated by using X-ray. Joint func- tion, relative length of ulna shortening, radial articular surface inclination ruler, wrist deviation rate, Krimmer wrist function and other indicators of patients were observed. Results After operation, relative length of ulna shortening, ra- dial articular surface inclination ruler, wrist deviation rate, elbow, elbow, forearm pronation of patients were significant- ly improved than before surgery, with statistical differences （P 〈 0.05）. After operation, wrist flexion, wrist extension and radial deviation of patients were significantly higher than before surgery, with statistical differences （P 〈 0.05）. Ul- nar deviation of patient before and after surgery was compared, with no statistical difference （P 〉 0.05）. Evaluation co- incidence rate of Krimmer wrist joint function score of patient after surgery was 100.0%, higher than before surgery （78.9%）, with statistical difference （P 〈 0.05）. Conclusion Effect of callus lengthening in the treatment of ulna distal HME induced forearm deformity is satisfactory, it is worthy of popularization and application.