改良前臂背侧筋膜脂肪瓣治疗创伤性尺桡骨骨性连接_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 王孝辉

河南省洛阳正骨医院河南省骨科医院手显微外科, 河南洛阳, 471002;

Corresponding author：

王孝辉, Email: 963099784@qq.com

Keywords：

尺桡骨骨性连接; 筋膜脂肪瓣; 骨折; 并发症

DOI：

10.7507/1002-1892.20160185

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目的总结改良前臂背侧筋膜脂肪瓣治疗创伤性尺桡骨骨性连接的疗效。方法 2007年3月-2013年6月，采用改良前臂背侧筋膜脂肪瓣环绕尺骨治疗创伤性尺桡骨骨性连接患者12例。男7例，女5例；年龄18～60岁，平均23.5岁。单一骨折2例，双骨折10例。伤后均行切开复位钛板内固定治疗。内固定术后至该次手术时间为9～15个月，平均11.5个月。按Hastings及Graham分类标准：3区4例，4区8例。3区患者前臂旋转范围为（18.0±3.5）°，4区患者为（20.0±4.5）°。肘关节功能Mayo评分为（55.0±4.5）分，上肢功能评定表（DASH）评分为（56.0±7.5）分。结果患者术后切口均Ⅰ期愈合。12例均获随访，随访时间1.6～2.7年，平均2.0年。2例合并骨间背神经损伤者术后存在前臂背侧局部感觉麻木，6个月后症状消失。X线片复查示，术后4个月3区及4区患者各1例原骨性愈合处少许骨质生长，但骨性连接未形成；其余患者未见骨质再生。末次随访时，患者前臂主动旋转功能均较术前显著改善；其中3区患者前臂旋转范围为（144.0±3.5）°，4区患者为（135.0±4.5）°，与术前比较差异有统计学意义（t=2.738，P=0.038；t=5.872，P=0.006）。Mayo评分为（87.5±5.5）分，DASH评分为（12.5±4.5）分，与术前比较差异均有统计学意义（t=2.283，P=0.027；t=4.765，P=0.008）。结论前臂背侧改良筋膜脂肪瓣治疗创伤性尺桡骨骨性连接，患者前臂旋转功能改善明显。

Citation： 王孝辉. 改良前臂背侧筋膜脂肪瓣治疗创伤性尺桡骨骨性连接. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(7): 919-920. doi: 10.7507/1002-1892.20160185 Copy

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1. Sonderegger J, Gidwani S, Ross M. Preventing recurrence of radiolunar synostosis with pedicled adipofascial flaps. J Hand Surg (Eur Vol), 2012, 37(3): 244-250.
2. Hastings H 2nd, Graham TJ. The classfication and treatment of heterotopic ossification about the elbow and forearm. Hand Clin, 1994, 10(3): 417-437.
3. Vince KG, Miller JE. Cross-union complicating fracture on the forearm. PartⅡ: Children. J Bone Joint Surg (Am), 1987, 69(5): 654-661.
4. Wierer M, Huber-Wagner S, Mutschler W. Post-traumatic proximal radioulnar synostosis. Surgical technique and review of the literature. Unfallchirurg, 2012, 115(5): 451-456.
5. Daluiski A, Schreiber JJ, Paul S, et al. Outcomes of anconeus interposition for proximal radioulnar synostosis. J Shoulder Elbow Surg, 2014, 23(12): 1882-1887.
6. Kamrani RS, Ahangar P, Nabian MH. Proximal radial diaphyseal segment resection for posttraumatic proximal radioulnar synostosis: a prospective study of 15 cases. J Shoulder Elbow Surg, 2014, 23(6): 855-860.
7. Dohn P, Khiami F, Rolland E, et al. Adult post-traumatic radioulnar synostosis. Orthop Traumatol Surg Res, 2012, 98(6): 709-714.

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Chinese Journal of Reparative and Reconstructive Surgery

改良前臂背侧筋膜脂肪瓣治疗创伤性尺桡骨骨性连接

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