肱骨髁上成角旋转中心微创截骨外固定治疗青少年肘内翻畸形

目的 :探讨采用肱骨髁上成角旋转中心(center of roration of angulation,CORA)微创截骨外固定治疗青少年肘内翻畸形的临床疗效。方法:自2013年8月至2017年8月,采用CORA微创截骨外固定治疗肱骨髁上骨折导致的青少年肘内翻畸形患者15例,其中男9例,女6例;年龄13～16岁,平均14.5岁;左侧11例,右侧4例;受伤至手术时间6～10年,平均7.5年,其中5例有肘内翻手术史术后复发。观察患者的矫正时间、骨折愈合时间及提携角,并采用Laupattarakasem标准进行疗效评价。结果:15例患者获得随访,时间12～30个月,平均24个月;畸形矫正时间3～5周,平均4周;骨愈合时间4～6个月,平均5个月;提携角由术前的-12°～-23°提高至术后的9°～14°。根据Laupattarakasem标准,本组优11例,良3例,可1例。结论:采用肱骨髁上CORA微创截骨外固定治疗青少年肘内翻畸形,具有微创、出血少、术后早期功能锻炼,矫形速度、角度可控,无须住院取除外固定等优点。

Minimally invasive external fixation of humeral supracondylar angular rotation center for the treatment of cubitus varus deformity in adolescents

Objective: To investigate clinical effect of minimally invasive osteotomy and external fixation with the center of roration of angulation (CORA) in treating cubitus varus in adolescents. Methods: From August 2013 to August 2017,15 patients with cubitus varus caused by supracondylar fracture of humerus were treated with minimally invasive osteotomy and external fixation with the CORA. Among them,including 9 males and 6 females;11 patients on the left side and 4 patients on the right side;aged from 13 to 16 years old with an average of 14.5 years old. The time from injury to operation was for 6 to 10 years with an average of 7.5 years. Five patients had a history of recurrence after cubitus varus surgery. Correction time. fracture healing time,carrying angle were observed,Laupattarakasem standard was used to evaluate clinical effect. Results: All patients were followed up from 12 to 30 months with an average of 24 months;correction time ranged from 3 to 5 weeks with an average of 4 weeks;fracture healing time ranged from 4 to 6 months with an average of 5 months;carrying angle before operation ranged from -12° to -23°,and improved 9° to 14° after operation. According to Laupattarakasem evaluation criteria,11 patients got an excellent result,3 good and 1 fair. Conclusion: Minimally invasive osteotomy and external fixation with CORA in treating cubitus varus deformity in adolescents has advantages of less trauma,less blood loss,earlier exercise,speed and angle of correction could controlled without hospitalized for fixation.