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首页> 外文期刊>Journal of pediatric orthopaedics. Part B >Gradual ulnar lengthening by an Ilizarov ring fixator for correction of Masada IIb forearm deformity without tumor excision in hereditary multiple exostosis: preliminary results
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Gradual ulnar lengthening by an Ilizarov ring fixator for correction of Masada IIb forearm deformity without tumor excision in hereditary multiple exostosis: preliminary results

机译：渐进式尺尺延长伊利兹罗圈固定器，用于纠正Masada IIB前臂畸形，没有肿瘤切除遗传多重脱落：初步结果

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摘要

Bony exostoses are benign osteocartilaginous growths that start close to growth plates. Approximately 30-60% of patients have forearm deformities. The commonly encountered forearm deformities in these patients are bowing of the radius, with or without ulnar drift of the carpus, radial head dislocation, shortening of the ulna, and radial head dislocation. The current study reported on the results of management of radial head dislocation for type IIb Masada and Oho classification of forearm deformities by Ilizarov ulnar lengthening and without tumor excision. A series of 12 patients with Masada type IIb deformity were treated by Ilizarov lengthening at AlHadra University Hospital, Alexandria, Egypt, during the period from January 2008 to June 2014. There were eight males and four females; the right forearm was affected in seven patients. The mean age of the patients was 8.7 years (range: 7.5-10 years). All cases showed ulnar shortening with distal ulnar exostosis and radial head dislocation (Masada type IIb). All patients were operated on under general anesthesia, with application of the Ilizarov frame to the forearm. The frame used was assembled of two complete rings; the proximal one was fixed to the proximal ulna and the distal ring was fixed to both radius and ulna. Ulnar osteotomy was performed between the two rings, followed by ulnar lengthening 10 days postoperatively to lengthen the ulna and pull down the radius. Over a follow-up period of 33.2 months (24-48 months), all patients showed spontaneous reduction of the radial head and correction of the forearm deformity. The range of motion improved: flexion increased from 117.5 degrees (110-130 degrees) to 145 degrees (130-160 degrees) and extension increased to 4.6 degrees (0-10 degrees), whereas it was 13.8 degrees (10-20 degrees) preoperatively and the supination increased from 46.3 degrees (40-50 degrees) preoperatively to 73.6 degrees (65-80 degrees) postoperatively. Pronation improved from a preoperative average of 37.9 degrees (30-40 degrees) to 70.8 degrees (60-80 degrees) at the end of follow-up. The average amount of ulnar length was 27.9 mm (25-35) and the duration of external fixation was 103.3 days on average, with a range of 90-130. Thus, the average external fixation index was 3.7 days/mm (range: 3.6-4.0). Gradual lengthening of the ulna and pulling down the radius with an Ilizarov frame is an excellent method for correction of forearm deformity in patients with multiple hereditary exostosis (Masada IIb). Early intervention is the key to achieving spontaneous reduction of the radial head in all patients without the need for corrective osteotomy or tumor excision.
机译：骨偏离是良性骨核酸生长，开始靠近生长板。大约30-60％的患者有前臂畸形。这些患者的通常遇到的前臂畸形是鞠躬的半径，有或没有甲颅骨漂移，径向头位错，尺骨缩短，径向头位错。目前的研究报告了ILIZAROV ULNAR延长的IIB型MASADA型射头头位数和OHO分类的径向脱位和OHO分类的结果。在2008年1月至2014年6月，Alhadra大学医院的Ilizarov延长延长了一系列12名Masada IIB患者的患者。有八月至2014年6月。右前臂在七名患者中受到影响。患者的平均年龄为8.7岁（范围：7.5-10岁）。所有病例均显示出尺骨缩短，远端尺骨脱落和径向头位错（Masada型IIB）。所有患者均在全身麻醉下进行操作，将Ilizarov框架施用于前臂。使用的框架组装在两个完整的环中;将近侧固定在近端尺骨上，远端环固定在半径和尺骨上。在两个环之间进行尺骨骨质术，然后在术后10天延长10天以延长尺骨并拉下半径。在33.2个月（24-48个月）的后续期间，所有患者均显示出自发减少径向头部和前臂畸形的校正。改善的运动范围：屈曲从117.5度（110-130度）增加到145度（130-160度），延伸增加到4.6度（0-10度），而它是13.8度（10-20度）术前，浸润从术前从46.3度（40-50度）增加到73.6度（65-80度）。在随访结束时，校牙从术前平均值37.9度（30-40度）到70.8度（60-80度）。平均尺尺长度为27.9mm（25-35），平均外固定持续时间为103.3天，范围为90-130。因此，平均外固定指数为3.7天/ mm（范围：3.6-4.0）。用Ilizarov帧逐渐延长尺寸并拉下半径的尺寸是校正多个遗传失败患者的前臂畸形（Masada Iib）的优异方法。早期干预是在不需要矫正截骨或肿瘤切除的情况下实现所有患者桡骨头的自发减少的关键。

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