Treatment of humeral shortening complicated with proximal deformity with a monorail external fixator
10.3760/cma.j.cn115530-20191026-00375
- VernacularTitle:单边轨道式延长外固定支架牵张治疗肱骨短缩合并近端畸形
- Author:
Mengwei WANG
1
;
Jia XU
;
Qinglin KANG
Author Information
1. 上海交通大学附属第六人民医院骨科 200233
- From:
Chinese Journal of Orthopaedic Trauma
2020;22(4):292-296
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the key technique and strategy in the treatment of humeral shortening complicated with proximal deformity using a monorail external fixator.Methods:We retro-spectively reviewed 10 patients (8 males and 2 females) with humeral shortening and proximal deformity who had been treated by a monorail external fixator between March 2015 and April 2018.Their mean age was 19.6 years (range, from 15 to 27 years).The humeral shortening was complicated with proximal varus in 8 cases, and with proximal varus plus kyphosis in 2.The affected humeri were 6 to 11 cm (mean, 8.5 cm) shorter than the normal ones.Half-pins were placed onto the lateral upper arm for installation of a unilateral external fixator to correct the proximal humeral deformity immediately after proximal osteotomy.Gradual lengthening was performed after osteotomy in the middle humeral shaft.The limb function was evaluated by the Cattaneo cri-teria.Results:All patients were followed up for 15 to 41 months (mean, 20 months).The length of lengthening ranged from 5 to 12 cm (mean, 7.5 cm).The range of shoulder abduction averaged 160° (from 130° to 180°), much improved than the preoperative average value (90°).Fine ossification was observed in the lengthening part in 9 patients but dysostosis in the lengthening part occurred in one patient who was healed after iliac autografting.No such complications as pin tract infection and radial nerve injury occurred.Ac-cording to the Cattaneo criteria, 9 limbs in 8 cases were excellent and 2 cases good.Conclusions:A monorail external fixator is a reliable choice for treatment of humeral shortening complicated with proximal deformity.To obtain satisfactory clinical effects, it is essential to master the installation technique of external fixator and prevent and control complications as well.
