摘要
目的探讨三维截骨导板在成人肘内翻畸形矫正中的应用价值。方法2013年4月—2015年9月,收治17例肘内翻畸形患者。男6例,女11例;年龄19~38岁,平均26.9岁。左侧10例,右侧7例。病程9~30年,平均18年。术前X线片测量患侧肘关节提携角为(-13.2±3.3)°、前倾角为(-10.5±2.3)°。肘关节伸直达(-10.0±2.5)°、屈曲达(127.3±7.3)°。术前根据CT扫描数据三维重建双侧肘关节,规划最佳截骨角度,设计三维截骨导板并在其辅助下完成截骨矫形手术。术后X线片复查测量肘关节提携角及前倾角,观察肘关节屈伸活动度。术后1年按照Oppenheim肘关节功能评分标准评定肘关节功能。结果手术均在三维截骨导板辅助下顺利完成。术后切口均Ⅰ期愈合。患者均获随访,随访时间12~15个月,平均13个月。X线片示截骨处均获骨性愈合,愈合时间9~12周,平均11周。术后1年,患侧肘关节提携角为(9.7±1.9)°、前倾角为(20.7±4.3)°,肘关节伸直达(2.6±3.5)°、屈曲达(139.2±4.8)°,均较术前明显增加(P<0.05);与健侧相比差异均无统计学意义(P>0.05)。术后1年按Oppenheim肘关节功能评分标准获优13例、良4例。随访期间未见神经损伤、肘关节骨化性肌炎等并发症发生。结论三维截骨导板可为成人肘内翻畸形截骨矫形术提供一种个性化、精准化的截骨治疗方案,并获得满意疗效。
Objective To investigate the effectiveness of three-dimensional(3D)navigation template in the adult cubitus varus osteotomy.Methods Between April 2013 and September 2015,17 patients with cubitus varus were admitted.There were 6 males and 11 females,aged from 19 to 38 years,with an average age of 26.9 years.There were 10 cases of left elbow joints and 7 cases of right elbow joints.The disease duration was 9-30 years(mean,18 years).Based on the preoperative X-ray film,the humerus-elbow-wrist(HEW)angle was(-13.2±3.3)°,the anteversion angle was(-10.5±2.3)°.The preoperative range of motion(ROM)of flexion was(127.3±7.3)°and ROM of extension was(-10.0±2.5)°.Based on the CT 3D reconstruction,the osteotomy navigation template was designed and printed by 3D printing technique.The cubitus varus osteotomy was assisted by 3D navigation template.The postoperative HEW angle,anteversion angle,and ROMs of the elbow joints of both sides were measured.The elbow function was evaluated based on the Oppenheim elbow function score at 1 year after operation.Results All cubitus varus osteotomies succeeded with the assist of 3D navigation template.All incisions healed by first intention.All patients were followed up 12-15 months(mean,13 months).X-ray films showed that all osteotomies healed after 9-12 weeks(mean,11 weeks).At 1 year after operation,the HEW angle was(9.7±1.9)°,the anteversion angle was(20.7±4.3)°,the ROM was(2.6±3.5)°in extension and(139.2±4.8)°in flexion of affected side.The HEW angle,anteversion angle,and ROMs significantly increased compared with preoperative values(P<0.05).And there was no significant difference between affected and normal elbow joints(P>0.05).The elbow functions were excellent in 13 cases and good in 4 cases based on the Oppenheim elbow function score at 1 year after operation.There was no complication such as the nerve injury or osteomyositis of elbow joint during follow-up.Conclusion The 3D navigation template can provide a personalized and precise osteotomy treatment for adult cubitus varus deformity and obtain a satisfactory effectiveness.
作者
杨二平
常祖豪
陈华
YANG Erping;CHANG Zuhao;CHEN Hua(Department of Orthopedics,Huanggang Central Hospital,Beijing,100853,P.R.China;Department of Orthopedics,First Medical Center of Chinese PLA General Hospital,Huanggang Hubei,438000,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2020年第7期831-835,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
肘内翻畸形
三维截骨导板
截骨术
3D打印
成人
Cubitus varus deformity
three-dimensional navigation template
osteotomy
three-dimensional printing
adults
