改良French内固定术治疗儿童肘内翻畸形的临床观察

目的探讨改良French内固定术治疗儿童肘内翻畸形的效果。方法儿童肘内翻畸形37例均行髁上楔形截骨术治疗,采用改良French内固定(A组)13例,单纯交叉克氏针内固定(B组)12例和钢板内固定(C组)12例,比较3组治疗前后肘关节活动度、提携角的变化及肘关节功能评价。结果 37例全部获得随访,随访时间2年～5年3个月。术后截骨处均在3个月左右骨性愈合,无一例再次出现肘内翻畸形,无神经损伤、感染等并发症。改良French内固定组优良率92.3%,显著优于单纯交叉克氏针内固定组和钢板内固定组(P<0.05);术后2年肘关节活动度(162.8±8.6)°,提携角(10.2±1.5)°,分别优于单纯交叉克氏针内固定组和钢板内固定组(P<0.05)。结论改良French内固定术治疗儿童肘内翻畸形,手术操作简单,局部创伤小,并发症少,取出内固定简单,术后肘关节活动度和提携角增加,临床效果满意,是一种安全、有效、较理想的肘内翻矫形方法。

Clinical observation on modified French internal fixation in treating children with cubitus varus deformity

Objective To explore the effects of modified French internal fixation in the treatment of children with cubitus varus deformity.Methods Totally 37 cases of cubitus varus from May 2006 to Jul.2009 were divided into three groups： modified French fixation group（group A）,cross Kirschner internal fixation group（group B） and plate internal fixation group（group C）.The range of elbow activity,changes of carrying angles and elbow joint function before and after treatment in the three groups were compared.Results All the 37 patients were followed up for 2 to 5.3 years.Bone union was observed in the osteotomy position 3 months postoperatively.There was no case of recurrence of cubitus varus deformity,nerve injury,infection and some other complications.The modified French internal fixation group had excellent and good rates of 92.3%,significantly better than those of cross Kirschner fixation group and plate fixation group（P0.05）;the range of elbow activity was（162.8±8.6） ° and the carrying angle was（10.2 ± 1.5） °at 2 years postoperatively,which were better than those of cross Kirschner fixation group and plate fixation group respectively（P0.05）.Conclusion The modified French internal fixation in the treatment of children with cubitus varus deformity has the advantages of simple operation,micro-trauma,fewer complications,easy removal of internal fixation,improvement of postoperative elbow activity and carrying angles,and satisfactory clinical effects.It is a safe,effective,and preferred method for treating cubitus varus correction.