儿童外伤性尺桡骨骨性连接的手术治疗

Surgical treatment for traumatic radioulnar synostosis in children

目的探讨儿童外伤性尺桡骨骨性连接的手术治疗效果.方法选取3例外伤性尺桡骨骨性连接患儿作为研究对象,均采用手术治疗,观察患儿功能恢复情况.结果3例患儿经随访6个月~3年(平均18个月),未出现骨性连接复发,术前平均旋前、旋后角度为8°和5°,术后平均旋前、旋后角度为70°和75°.2例前臂旋前为75°,1例为60°;2例前臂旋后为80°,1例为65°,功能恢复满意.女患儿(7岁)右侧尺桡骨多处粉碎性骨折行切开克氏针内固定术后4个月发生外伤性尺桡骨骨性连接.3例患儿切口均无感染.结论前臂背侧筋膜脂肪瓣能够有效治疗儿童外伤性尺桡骨骨性连接,避免复发,使得患儿前臂旋转功能改善明显.

Objective To discuss the treatment effect of surgical treatment for traumatic radioulnar synostosis in children. Methods 3 cases of traumatic radioulnar synostosis were selected as subjects and treated surgically. Observation were made on functional recovery inchildren. Results 3 patients were followed up for 6 months to 3 years (mean 18 months), and there was no recurrence of bony connection. The average preoperative pronation and supination angles were 8°and 5°, and the average postoperative pronation and supination angles were 70° and 75°. 2 cases of forearm pronation angle were 75°, 1 case was 60°, 2 cases of forearm supination angles were 80°, and 1 case was 65°. The function recovery was satisfactory. The female patient (7 years old) developed traumatic radioulnar synostosis 4 months after open Kirschner wire internal fixation for multiple comminuted fractures of the right ulna and radius. There was no infection in all incisions. Conclusion The dorsal fascial fat flap of the forearm is effective in treating traumatic radioulnar synostosis in children, and it can avoid recurrence and improve the rotation function of forearm in children.