Treatment of congenital radial longitudinal defciency in children with one-stage bilobed flap combined with centralization by circular external fixation
10.3760/cma.j.cn114453-20200326-00179
- VernacularTitle:一期双叶皮瓣联合环形外支架治疗儿童桡侧列发育不良
- Author:
Yongjun RUI
1
;
Xiaofang SHEN
;
Yongwei WU
;
Yongqiang KANG
;
Weifeng LIN
;
Fei YIN
;
Fang LIN
Author Information
1. 无锡市第九人民医院创伤骨科 214062
- Keywords:
Congenital absence of radius;
Radial longitudinal defciency;
Surrgical flap;
External fixation
- From:
Chinese Journal of Plastic Surgery
2020;36(7):751-756
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce the clinical experience and treatment effect of congenital radial longitudinal deficiency in children with one-stage bilobed flap combined with centralization by circular external fixation.Methods:Analysis and statistics from 14 children with radial longitudinal deficiency were summarized in our hospital from January 2006 to December 2018, 8 males and 6 females; aged 3 to 17 years, average 9.7 years. 3 patients on the left side, 10 patients on the right side, 1 case bilateral.1 case was type Ⅱ, 7 cases were type Ⅲ, 6 cases were type Ⅳ.2 cases were with scoliosis. The radial angulation of 30°- 90°(average 67.3°) before operation. In the first phase, bilobed flaps were used to completely release soft tissue and restore dynamic balance. After the centralization, it was fixed with a circular external fixation. Three cases underwent ulnar osteotomy and forearm extension at the same time. Follow-up indicators: Observe the flap survival in the short term, and follow up on the radial deviation of the wrist and the degree of wrist mobility for a long time.Results:In one patient, the distal part of the dorsal wrist flap was necrotic, the necrotic part was removed and directly sutured 12 days later, and the rest all survived. During a follow-up period of 2 to 8 years (average 3.6 years), the average radial angulation was 9.3° (2°to 17°), the average flexion of the wrist was 46.7°(25°to 70°), and the average extension was 14.7° (5°to 20°). One case which forearm extension had a fractured nonunion and bone graft with internal fixation was performed in 9th after surgery, and ulna healed in 3 months after bone grafting. The forearm radial deflection was significantly improved in all patients, and functional recovery was satisfactory.Conclusions:Treatment of radial longitudinal deficiency in children in one-stage bilobed flap combined with centralization by circular external fixation is an effective clinical treatment method. It can reduce the number of operations, obtain satisfactory appearance and receive good functional recovery.
