肱骨髁上截骨术后可吸收与金属张力带固定治疗肘内翻的研究

目的:比较肱骨髁上楔形截骨术后可吸收张力带(可吸收螺钉或棒和可吸收线)与金属张力带(克氏针和钢丝)固定治疗肘内翻的疗效。方法:采用2种张力带固定肱骨髁上楔形截骨术后骨端治疗33例肘内翻。可吸收张力带固定组15例,其中男12例,女3例;年龄13~24岁,平均16岁;术前内翻角为17°~34°,平均26°。金属张力带固定组18例,其中男15例,女3例;年龄12~22岁,平均14岁;术前内翻角为17°~40°,平均29°。根据术后畸形矫正和关节功能恢复情况评定疗效。结果:本组均获随访,随访时间18~69个月,平均37个月。截骨处平均愈合时间为6周。根据疗效评定标准,可吸收张力带组优13例,良2例,差0例;金属张力带组优15例,良2例,差1例。2种治疗方法临床疗效比较无统计学差异。结论:可吸收张力带是固定肱骨髁上截骨治疗肘内翻的有效方法之一,具有无须Ⅱ期手术取出内固定物的优点,简单方便,降低感染机会。

Comparison study on biodegradable and metallic tension band fixation for the treatment of cubitus varus after supercondylar humeral osteotomy

Objective: To compare the therapeutic effects between biodegradable tension band fixation(BTB)(including Biofix rods or DIKFIX screws and MAXON sutures) and metallic tension band fixation(MTB)(including Kirschner wire and cerclage wire) for the treatment of cubitus varus after supercondylar humeral osteotomy.Methods: Thirty-three patients with cubitus varus were treated with two methods in the study.Among 15 patients in BTB group,12 patients were male and 3 patients were female,ranging in age from 13 to 24 years,with an average of 16 years,and the cubitus varus angel ranged from 17 degree to 34 degree(mean 26 degree).Among 18 patients in MTB group,15 patients were male and 3 patients were female,ranging in age from 12 to 22 years,with an average of 14 years,and the cubitus varus angle ranged from 17 degree to 40 degree(mean 29 degree).The results were evaluated according to correction of deformity and recovery of joint function.Results: All the patients were followed(ranged,18 to 69 months),with an average of 37 months.Bone union occurred after a mean time of 6 weeks.In BTB group,13 patients gained an excellent result,2 good,0 poor.In MTB group,15 patients gained an excellent result,2 good,and 1 poor.There were no statistics differences in therapeutic effects between the two groups.Conclusion: Biodegradable tension band is believed to be a good simple method for the treatment of cubitus varus after supercondylar humeral osteotomy without necessary of second operation for removal of implants.