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首页> 外文期刊>Journal of shoulder and elbow surgery >Intra-articular osteotomy for malunited articular fractures of the distal end of the humerus
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Intra-articular osteotomy for malunited articular fractures of the distal end of the humerus

机译：肱骨远端关节畸形骨折的关节内截骨术

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Background: The precarious anatomy of the articular surface of the distal humerus, as well as its meager subchondral bony support and limited soft-tissue attachments, presents enormous challenges for the operative correction of post-traumatic intra-articular deformities. This study presents 8 patients who underwent articular osteotomy with a mean follow-up period of 10.6 years, with an emphasis on functional, patient-rated, and radiographic outcomes. Methods: Eight patients (mean age, 39 years; range, 17-60 years) were followed up for a mean period of 10.6 years. The original fracture was a type C variant in 4 patients, a type B unicondylar fracture in 2, and a type B articular shearing fracture in 2. The initial injury was treated operatively in 5 patients and nonoperatively in 3. The osteotomy and reconstruction were performed on average 8 months after injury (range, 6-11 months). The mean preoperative elbow arc of motion was 37°. Two patients had ulnar nerve dysfunction. Results: All the osteotomies healed after the index procedure without evidence of avascular necrosis. Two patients required a second procedure for stiffness. At follow-up, the mean arc of elbow motion improved to 104° (P = .001), with a mean flexion contracture of 26°. The mean Disabilities of the Arm, Shoulder and Hand score at follow-up was 13 (range, 1-37); the mean patient satisfaction rating on a Likert scale (from 0 to 10) was 9.1; and the mean Mayo Elbow Performance Index score was 83 points (range, 70-100 points). Grade II osteoarthritic changes were seen in 3 patients, grade I in 3, and grade 0 in2. Conclusions: In selected patients with a defined intra-articular malunion, the results of our experience support corrective osteotomy.
机译：背景：肱骨远端关节表面的不稳定解剖结构，软骨下骨的微弱支撑和有限的软组织附着，为创伤后关节内畸形的手术矫治提出了巨大的挑战。这项研究介绍了8例接受了关节截骨术的患者，平均随访期为10.6年，重点是功能，患者评分和影像学检查结果。方法：对8例患者（平均年龄39岁;范围17-60岁）进行了随访，平均时间为10。6年。原始骨折为4例C型变体，2例为B型单icon突骨折，2例为B型关节剪切骨折。5例患者接受手术治疗，3例接受手术治疗。受伤后平均8个月（范围6-11个月）。术前肘关节平均运动弧度为37°。 2例尺神经功能障碍。结果：所有切骨术均在索引手术后after愈，无血管坏死迹象。两名患者需要进行第二次僵硬手术。随访时，平均肘部运动弧度提高至104°（P = .001），平均屈曲挛缩度为26°。随访时手臂，肩膀和手部的平均残疾评分为13（范围：1-37）;患者的李克特量表（从0到10）的平均满意度为9.1; Mayo Elbow Performance Index的平均得分为83分（范围70-100分）。 3例患者出现II级骨关节炎变化，3例患者为I级，2例患者为0级。结论：在选定的具有明确关节内畸形的患者中，我们的经验结果支持矫正截骨术。

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