摘要
目的探讨辅助应用医学影像存档和传输系统（PACS）设计改良肱骨髁上等腰三角形截骨矫形并联合锁定钢板内固定治疗肘内翻畸形的效果。方法回顾性分析2012年1月至2016年7月期间收治的31例肘内翻畸形患者资料。男12例，女19例；年龄为17～24岁，平均20．6岁；肘内翻角为14°～35°，平均22．4°。术前使用PACS辅助对肘内翻畸形患者进行改良肱骨髁上等腰三角形截骨设计，根据截骨角度计算等腰三角形截骨长度，测量出截骨角度及长度，术中均行外侧切开改良等腰三角形截骨矫形联合锁定钢板内固定。结果31例患者术后获12～40个月（平均16个月）随访。31例患者截骨处均获骨性愈合，愈合时间为7—12周，平均9周。末次随访时提携角为8°～15°，平均11o；患侧肘关节屈伸活动范围为126°～150°，平均139°；旋转范围为134°～160°，平均144°。术后1年采用Mayo肘关节功能评分标准评定疗效：优23例，良7例，中1例，优良率为96．8％。随访期间未见提携角丢失、神经损伤、骨折畸形愈合及延迟愈合、肘关节骨化性肌炎等并发症发生。结论术前辅助应用PACS对肘内翻畸形患者进行改良肱骨髁上等腰三角形设计，可以精确指导术中截骨长度并确保矫正角度，获得良好疗效。
Objective To investigate application of modified isosceles triangle osteotomy which is designed with the assistance of Picture Archiving and Communication System （PACS） in supracondylar surgery for cubitus varus. Methods We reviewed the 31 patients who had been treated for cubitus varus from January 2012 to July 2017. They were 12 males and 19 females, aged from 17 to 24 years （average, 20.6 years） . Their elbow varus angles ranged from 14°to 35° （average, 22. 4°） . Preoperatively, the modified isosceles triangle osteotomy was designed using the PACS. The angle of osteotomy = carrying angle of the normal arm ＋ the angle of cubitus varus. The lateral length of the isosceles triangle osteotomy was calculated according to the osteotomy angle. All the cases were fixated with a locking plate. Results The follow-ups lasted from 12 to 40 months （average, 16 months）. Bony union was achieved in the osteotomy site by all cases after 7 to 12 weeks （average, 9 weeks） . The carrying angles ranged from 8° to 15° （average, 11°） at final follow-ups. The affected elbow obtained a range of flexion and extension from 126° to 150° （average, 139°） and a range of rotation from 134° to 160° （144°） . According to the Mayo elbow performance score （MEPS） one year after operation, 23 cases were rated as excellent, 7 as good and one as fair, yielding an excellent to good rate of 96.8%. No loss of carrying angle, neural deficit, malunion, delayed union, or myositis ossifi- cans of the elbow was observed during the follow-ups. Conclusion The PACS can be used in preoperative design of the modified isosceles triangle osteotomy for cubitus varus, leading to accuracy in the angle and length of the osteotomy to guarantee fine clinical results.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2018年第1期16-21,共6页
Chinese Journal of Orthopaedic Trauma
关键词
肘内翻
截骨
骨折固定术
内
骨板
医学影像存档和传输系统
Cubitus varus
Osteotomy
Fracture fixation, internal
Bone plates
Picture Archiving and Communication System
