对先天性桡偏手患儿进行撑开的连骨术延长尺骨

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论证：先天性桡偏手的特点是手臂的辐射偏差、前臂缩短和上肢功能受限。尺骨缩短发生在所有类型的桡偏手。手术治疗前，尺骨较完整肢体尺骨平均缩短33.3%。

目的是根据III型、IV型先天性桡偏手患者的截骨水平，评价牵张接骨法治疗肘骨延长的效果。

材料与方法：回顾性分析1998-2018年36位先天性IV型桡偏手患者的治疗结果。平均年龄7.4 ± 3.5岁。根据尺骨切骨术水平将患者分为三组。分析了主要指标：尺骨变形角度的缩短和矫正百分率，手的径向偏差，矫正时间，获得的伸长率，固定和连骨术指数，并发症。

结果：患者观察期平均5.8年。手术前，尺骨对于正常的一肢缩短百分比33.3%，手术后为16%。
术前尺骨变形角度为20,5 ± 14,8度，术后为7,4 ± 5,6度，得到的变形角矫正矫正率为63.9%。尺骨延长了3.2 ± 1.1厘米。尺骨近端部切骨术的患者中伸长率比中、下三分之二切骨术的患者相关高
32%及18.4%。第一组的矫正期比第二、第三组相关长24.4％和28.9％。第一组固定指数比第二、
三组分别低53.6、45.7%。最常见的并发症是假关节的形成(15%)、炎症过程(10%)和前臂的继发性
畸形(7.5%)。

结论：研究表明，对于III型、IV型先天性桡偏手患者，尺骨延长的最佳切骨术区是其近段。但是，
当手的偏斜超过20时，建议在尺远端切骨术同时矫正畸形。

作者简介

Natalia Avdeychik

The Turner Scientific Research Institute for Children’s Orthopedics

编辑信件的主要联系方式.
Email: natali_avdeichik@mail.ru
ORCID iD: 0000-0001-7837-4676
SPIN 代码: 6059-4464
Scopus 作者 ID: 57193273547

MD, Orthopedic and Trauma Surgeon of the Department of Reconstructive Microsurgery and Hand Surgery

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Sergey Golyana

The Turner Scientific Research Institute for Children’s Orthopedics

Email: ser.golyana@yandex.ru
ORCID iD: 0000-0003-1319-8979

MD, PhD, scientific supervisor department of reconstructive microsurgery and hand surgery

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Denis Grankin

The Turner Scientific Research Institute for Children’s Orthopedics

Email: grankin.md@gmail.com
ORCID iD: 0000-0001-8948-9225

MD, Research Associate of the Department of Reconstructive Microsurgery and Hand Surgery

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Andrey Safonov

The Turner Scientific Research Institute for Children’s Orthopedics

Email: safo125@gmail.com
ORCID iD: 0000-0003-1923-7289

MD, PhD, chief of the department of reconstructive microsurgery and hand surgery.

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

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补充文件

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1. JATS XML
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2. 图 1。P患者上肢x线片，5岁，尺骨加长前(a)，切骨术后(b)， 固定期结束时(c)，3年后(d, e)

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3. 图 2。病人L上肢x线片，6岁，尺骨加长前(a)，切骨术后(b)，2年后(c)

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