• 廣州軍區(qū)總醫(yī)院骨科醫(yī)院全軍創(chuàng)傷骨科中心（廣州，510010）;

目的 探討肱骨髁上截骨雙鋼板固定治療成人創(chuàng)傷后肘內(nèi)翻的方法及療效。 方法 回顧性分析2007 年6 月－ 2010 年12 月手術(shù)治療22 例成人創(chuàng)傷后肘內(nèi)翻畸形患者的臨床資料。其中男16 例，女6 例；年齡18 ～ 29 歲，平均21 歲。既往均有肱骨髁上骨折病史；初次骨折后3 個月～ 1 年，平均6 個月出現(xiàn)肘內(nèi)翻畸形；出現(xiàn)畸形后4 ～ 17 年，平均8 年入院手術(shù)。術(shù)前患側(cè)肘關(guān)節(jié)提攜角為肘內(nèi)翻16 ～ 25°，平均20.6°。肘關(guān)節(jié)功能采用Flynn 評分均為差。術(shù)中行肱骨外側(cè)閉合楔形截骨，以2 塊重建鋼板塑形后分別置于肱骨內(nèi)外側(cè)柱以固定截骨斷端。術(shù)后無需外固定，早期行功能鍛煉。 結(jié)果 術(shù)后切口均Ⅰ期愈合。22 例均獲隨訪，隨訪時間6 ～ 24 個月，平均13 個月。末次隨訪時患側(cè)肘關(guān)節(jié)提攜角為肘外翻0 ～ 10°，平均7.5°?；颊呓毓翘幘切杂?，愈合時間8 ～ 13 周，平均10 周。術(shù)后無感染，神經(jīng)、血管損傷，內(nèi)固定物松動、斷裂等并發(fā)癥發(fā)生，無肘內(nèi)翻復(fù)發(fā)。末次隨訪時Flynn 評分優(yōu)17 例，良3 例，中2 例，優(yōu)良率91%。 結(jié)論 采用肱骨髁上截骨加雙鋼板固定治療成人創(chuàng)傷后肘內(nèi)翻畸形，固定堅(jiān)強(qiáng)，骨折愈合率高，術(shù)后能早期功能鍛煉，肘關(guān)節(jié)功能恢復(fù)滿意。

引用本文： 肖進(jìn) ,吳文,趙曉亮,魏冀榮,郭曉澤,尹慶水,章瑩. 成人創(chuàng)傷后肘內(nèi)翻畸形的矯形及雙柱固定. 中國修復(fù)重建外科雜志, 2012, 26(4): 425-428. doi: 復(fù)制

1. Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg (Am), 2008, 90(5): 1121-1132.
2. Koh KH, Seo SW, Kim KM, et al. Clinical and radiographic results of lateral condylar fracture of distal humerus in children. J Pediatr Orthop, 2010, 30(5): 425-429.
3. Canale ST. 坎貝爾骨科手術(shù)學(xué). 盧世璧, 主譯. 3版. 濟(jì)南: 山東科學(xué)技術(shù)出版社, 2003: 2358.
4. Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of humerus in children. Sixteenyears’ experience with long-term follow-up. J Bone Joint Surg (Am), 1974, 56(2): 263-272.
5. 郭躍明, 王志遠(yuǎn), 鄒勇根, 等. 肱骨髁上骨折并發(fā)肘內(nèi)翻畸形病理形態(tài)學(xué)分析. 中國矯形外科雜志, 2004, 12(10): 726-727.
6. Eren A, Güven M, Erol B, et al. Correlation between posteromedial or posterolateral displacement and cubitus varus deformity in supracondylar humerus fractures in children. J Child Orthop, 2008, 2(2): 85-89.
7. Mortazavi SM, Heidari P, Asadollahi S, et al. Severe tardy ulnar nerve palsy caused by tuarmatic cubitus valgus deformity: functional outcome of subcutaneous anterior tuansposition. J Hand Surg (Eur), 2008, 33(5): 575-580.
8. Di Rocco F, Doglietto F, Tufo T, et al. Posttuaumatic immobilization in flexion of a congenital valgus elbow and cubital tunnel syndrom-case report. Surg Neurol, 2009, 71(6): 709-712.
9. Meyer RA Jr, Tsahakis PJ, Martin DF, et al. Age and ovariectomy impair both the normalization of mechanical properties and the accretion of mineral by the fracture callus in rats. J Orthop Res, 2001, 19(3): 428-435.
10. Lu C, Miclau T, Hu D, et al. Celluar basis for age-related changes in fracture repair. J Orthop Res, 2005, 23(6): 1300-1307.
11. Helfet DL, Kloen P, Anand N, et al. Open reduction and internal fixation of delayed unions and nonunions of fractures of the distal part of the humerus. J Bone Joint Surg (Am), 2003, 85-A(1): 33-40.
12. Butt MF, Dhar SA, Farooq M, et al. Lateral invaginating peg (LIP) osteomy for the correction of post-traumatic cubitus varus deformity. J Pediatr Orthop B, 2009, 18(5): 265-270.
13. Gong HS, Chung MS, Oh JH, et al. Oblique closing wedge osteotomy and lateral plating for cubitus varus in adults. Clin Orthop Relat Res, 2008, 466(4): 899-906.
14. Hahn SB, Choi YR, Kang HJ. Corrective dome osteotomy for cubitus varus and valgus in adults. J Shoulder Elbow Surg, 2009, 18(1): 38-43.
15. Moon MS, Kim SS, Kim ST, et al. Lateral closing wedge osteotomy with or without medialisation of the distal fragment for cubitus varus. J Orthop Surg (Hong Kong), 2010, 18(2): 220-223.
16. Davids JR, Lamoreaux DC, Brooker RC, et al. Translation step-cut osteotomy for the treatment of posttraumatic cubitus varus. J Pediatr Orthop, 2011, 31(4): 353-365.
17. Takagi T, Takayama S, Nakamura T, et al. Supracondylar osteotomy of the humerus to correct cubitus varus: do both internal rotation and extension deformities need to be corrected? J Bone Joint Surg (Am), 2010, 92(7): 1619-1626.
18. Li SH, Li ZH, Cai ZD, et al. Bilateral plate fixation for type C distal humerus fractures: experience at a single institution. Int Orthop, 2011, 35(3): 433-438.
  1. 1. Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg (Am), 2008, 90(5): 1121-1132.
  2. 2. Koh KH, Seo SW, Kim KM, et al. Clinical and radiographic results of lateral condylar fracture of distal humerus in children. J Pediatr Orthop, 2010, 30(5): 425-429.
  3. 3. Canale ST. 坎貝爾骨科手術(shù)學(xué). 盧世璧, 主譯. 3版. 濟(jì)南: 山東科學(xué)技術(shù)出版社, 2003: 2358.
  4. 4. Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of humerus in children. Sixteenyears’ experience with long-term follow-up. J Bone Joint Surg (Am), 1974, 56(2): 263-272.
  5. 5. 郭躍明, 王志遠(yuǎn), 鄒勇根, 等. 肱骨髁上骨折并發(fā)肘內(nèi)翻畸形病理形態(tài)學(xué)分析. 中國矯形外科雜志, 2004, 12(10): 726-727.
  6. 6. Eren A, Güven M, Erol B, et al. Correlation between posteromedial or posterolateral displacement and cubitus varus deformity in supracondylar humerus fractures in children. J Child Orthop, 2008, 2(2): 85-89.
  7. 7. Mortazavi SM, Heidari P, Asadollahi S, et al. Severe tardy ulnar nerve palsy caused by tuarmatic cubitus valgus deformity: functional outcome of subcutaneous anterior tuansposition. J Hand Surg (Eur), 2008, 33(5): 575-580.
  8. 8. Di Rocco F, Doglietto F, Tufo T, et al. Posttuaumatic immobilization in flexion of a congenital valgus elbow and cubital tunnel syndrom-case report. Surg Neurol, 2009, 71(6): 709-712.
  9. 9. Meyer RA Jr, Tsahakis PJ, Martin DF, et al. Age and ovariectomy impair both the normalization of mechanical properties and the accretion of mineral by the fracture callus in rats. J Orthop Res, 2001, 19(3): 428-435.
  10. 10. Lu C, Miclau T, Hu D, et al. Celluar basis for age-related changes in fracture repair. J Orthop Res, 2005, 23(6): 1300-1307.
  11. 11. Helfet DL, Kloen P, Anand N, et al. Open reduction and internal fixation of delayed unions and nonunions of fractures of the distal part of the humerus. J Bone Joint Surg (Am), 2003, 85-A(1): 33-40.
  12. 12. Butt MF, Dhar SA, Farooq M, et al. Lateral invaginating peg (LIP) osteomy for the correction of post-traumatic cubitus varus deformity. J Pediatr Orthop B, 2009, 18(5): 265-270.
  13. 13. Gong HS, Chung MS, Oh JH, et al. Oblique closing wedge osteotomy and lateral plating for cubitus varus in adults. Clin Orthop Relat Res, 2008, 466(4): 899-906.
  14. 14. Hahn SB, Choi YR, Kang HJ. Corrective dome osteotomy for cubitus varus and valgus in adults. J Shoulder Elbow Surg, 2009, 18(1): 38-43.
  15. 15. Moon MS, Kim SS, Kim ST, et al. Lateral closing wedge osteotomy with or without medialisation of the distal fragment for cubitus varus. J Orthop Surg (Hong Kong), 2010, 18(2): 220-223.
  16. 16. Davids JR, Lamoreaux DC, Brooker RC, et al. Translation step-cut osteotomy for the treatment of posttraumatic cubitus varus. J Pediatr Orthop, 2011, 31(4): 353-365.
  17. 17. Takagi T, Takayama S, Nakamura T, et al. Supracondylar osteotomy of the humerus to correct cubitus varus: do both internal rotation and extension deformities need to be corrected? J Bone Joint Surg (Am), 2010, 92(7): 1619-1626.
  18. 18. Li SH, Li ZH, Cai ZD, et al. Bilateral plate fixation for type C distal humerus fractures: experience at a single institution. Int Orthop, 2011, 35(3): 433-438.