EFFECTIVENESS OF Ilizarov TECHNIQUE IN TREATMENT OF OLD DISLOCATION OF RADIAL HEAD_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CAOYujing ¹ ,  LIYang ² , MINGXinwu ³ , MINGXinyue ³ , FUKeda ² , LIANHuijuan ² , SHENShouren ³ , DONGHailiang ³

1. Department of Traumatic Orthopedics, Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou Henan, 450000, P. R. China;
2. Second Clinical Medical College of Henan University of Traditional Chinese Medicine;
3. Department of Children Orthopedics, Huaxian Orthopedics Hospital of Henan Province;

Corresponding author：

LIYang, Email: liyang2013317@163.com

Keywords：

Radial head dislocation; Ilizarov technique; Ulnar osteotomy; Children

DOI：

10.7507/1002-1892.20150318

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Objective To explore the effectiveness of modified Ilizarov semi-ring external fixator combined with an ulnar osteotomy lengthening in the treatment of old dislocation of the radial head in children. Methods A retrospective analysis was made on the data of 14 patients with old dislocation of the radial head treated by the modified Ilizarov semi-ring external fixator combined with ulnar osteotomy lengthening between March 2012 and January 2015. The age ranged from 2 to 13 years (mean, 7.2 years), including 12 boys and 2 girls. There was 1 case of congential dislocation of the radial head and 13 cases of old Monteggia fracture. According to the Bado's classification, dislocation was rated as grade Ⅰ in 12 cases and grade Ⅲ in 2 cases. The elbow flexion-extension and forearm pronation and supination were compared between at pre- and post-operation; Mackay evaluation standard of elbow joint function was used to evaluate the effectiveness. Results The operation time ranged from 50 to 65 minutes (mean, 58 minutes). All patients were followed up 6-33 months (mean, 21 months). No complication of infection, myositis ossificans, or redislocation occurred. X-ray film showed bony healing at ulnar osteotomy site within 82-114 days (mean, 90 days). The elbow flexion-extension and forearm pronation and supination were significantly improved at postoperation when compared with preoperation (P<0.05). The results of Mackay function assessment were excellent in 12 cases and good in 2 cases. Conclusion The modified Ilizarov semi-ring external fixator combined with an ulnar osteotomy lengthening has the advantages of small incision, easy removal of fixator, satisfactory reduction, and no nonunion at ulnar osteotomy site in the treatment of old dislocation of the radial head, but the long-term effectiveness still needs to be followed up.

Citation： CAOYujing, LIYang, MINGXinwu, MINGXinyue, FUKeda, LIANHuijuan, SHENShouren, DONGHailiang. EFFECTIVENESS OF Ilizarov TECHNIQUE IN TREATMENT OF OLD DISLOCATION OF RADIAL HEAD. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(12): 1483-1487. doi: 10.7507/1002-1892.20150318 Copy

1.	黄金承, 连鸿凯, 白玉, 等. 儿童陈旧性孟氏骨折不同手术方式的临床疗效探讨. 中国骨与关节损伤, 2013, 2(9):526-530.
2.	詹青霞, 武钢, 蒋黛蒂, 等. 儿童肘关节常见骨折的DR诊断体会. 中国医学计算机成像杂志, 2012, 18(6):522-524.
3.	杨生敏. 儿童肘关节损伤的X线诊断漏诊原因分析. 中国伤残医学, 2014, 22(9):185-186.
4.	王军强, 龚晓峰, 张健, 等. 临床病例讨论——Bado ⅡA型孟氏骨折的诊断与治疗. 中华创伤骨科杂志, 2009, 11(11):1098-1110.
5.	黄佳平, 郭林新, 张焕堂, 等. 2种截骨方式治疗儿童陈旧性孟氏骨折的疗效比较. 中国骨与关节损伤, 2015, 30(3):284-286.
6.	Jochymek J, Straka M, Skvaĭiln J, et al. Treatment of sequelae after Monteggia lesions in childhood. Acta Chir Orthop Traumatol Cech, 2012, 79(1):48-51.
7.	韩鹏, 郭淑华. 尺骨截骨延长钢板内固定加克氏针固定肱桡关节治疗儿童陈旧性孟氏骨折. 中国实用医药, 2014, 9(7):130-131.
8.	Pesl T, Havránek P. Monteggia lesions in the growing skeleton:principles of therapy. Acta Chir Orthop Traumatol Cech, 2010, 77(1):32-38.
9.	Bado JL. The Monteggia lesion. Clin Orthop Relat Res, 1967, (50):71-86.
10.	Mackay I, Fitzgerald B, Miller JH. Silaslic replacement of the head of the radius in trauma. J Bone Joint Surg (Br), 1979, 61-B(4):494-497.
11.	赵宝成, 袁天祥, 马宝通. 前臂纵向分离的研究进展. 中国矫形外科杂志, 2014, 22(9):808-811.
12.	罗永忠, 李佩佳, 赵汉平, 等. 尺骨截骨及外固定架联合治疗儿童陈旧性桡骨小头前脱位. 中国矫形外科杂志, 2006, 14(4):266-268.
13.	Bilen FE, Kocaoğlu M, Eralp L. Indirect reduction of the radial head using an external fixator to treat chronic radial head dislocations. Acta Orthop Traumatol Turc, 2010, 44(1):14-19.
14.	李浪, 黄奇, 高峰, 等. Ilizarov技术结合非融合理念矫治创伤后马蹄内翻足. 中国修复重建外科杂志, 2014, 28(7):823-827.
15.	臧建成, 秦泗河. 从Woff定律和Ilizarov张力-应力法则到骨科自然重建理念. 中国骨伤, 2013, 26(4):287-290.
16.	刘振东, 秦泗河. 骨延长的骨愈合原理. 医学与哲学, 2014, 35(10B):11-13.
17.	曾裴, 杨建平, 任秀智, 等. 儿童陈旧性孟氏骨折的手术治疗. 中华骨科杂志, 2012, 32(5):457-461.

1. 黄金承, 连鸿凯, 白玉, 等. 儿童陈旧性孟氏骨折不同手术方式的临床疗效探讨. 中国骨与关节损伤, 2013, 2(9):526-530.
2. 詹青霞, 武钢, 蒋黛蒂, 等. 儿童肘关节常见骨折的DR诊断体会. 中国医学计算机成像杂志, 2012, 18(6):522-524.
3. 杨生敏. 儿童肘关节损伤的X线诊断漏诊原因分析. 中国伤残医学, 2014, 22(9):185-186.
4. 王军强, 龚晓峰, 张健, 等. 临床病例讨论——Bado ⅡA型孟氏骨折的诊断与治疗. 中华创伤骨科杂志, 2009, 11(11):1098-1110.
5. 黄佳平, 郭林新, 张焕堂, 等. 2种截骨方式治疗儿童陈旧性孟氏骨折的疗效比较. 中国骨与关节损伤, 2015, 30(3):284-286.
6. Jochymek J, Straka M, Skvaĭiln J, et al. Treatment of sequelae after Monteggia lesions in childhood. Acta Chir Orthop Traumatol Cech, 2012, 79(1):48-51.
7. 韩鹏, 郭淑华. 尺骨截骨延长钢板内固定加克氏针固定肱桡关节治疗儿童陈旧性孟氏骨折. 中国实用医药, 2014, 9(7):130-131.
8. Pesl T, Havránek P. Monteggia lesions in the growing skeleton:principles of therapy. Acta Chir Orthop Traumatol Cech, 2010, 77(1):32-38.
9. Bado JL. The Monteggia lesion. Clin Orthop Relat Res, 1967, (50):71-86.
10. Mackay I, Fitzgerald B, Miller JH. Silaslic replacement of the head of the radius in trauma. J Bone Joint Surg (Br), 1979, 61-B(4):494-497.
11. 赵宝成, 袁天祥, 马宝通. 前臂纵向分离的研究进展. 中国矫形外科杂志, 2014, 22(9):808-811.
12. 罗永忠, 李佩佳, 赵汉平, 等. 尺骨截骨及外固定架联合治疗儿童陈旧性桡骨小头前脱位. 中国矫形外科杂志, 2006, 14(4):266-268.
13. Bilen FE, Kocaoğlu M, Eralp L. Indirect reduction of the radial head using an external fixator to treat chronic radial head dislocations. Acta Orthop Traumatol Turc, 2010, 44(1):14-19.
14. 李浪, 黄奇, 高峰, 等. Ilizarov技术结合非融合理念矫治创伤后马蹄内翻足. 中国修复重建外科杂志, 2014, 28(7):823-827.
15. 臧建成, 秦泗河. 从Woff定律和Ilizarov张力-应力法则到骨科自然重建理念. 中国骨伤, 2013, 26(4):287-290.
16. 刘振东, 秦泗河. 骨延长的骨愈合原理. 医学与哲学, 2014, 35(10B):11-13.
17. 曾裴, 杨建平, 任秀智, 等. 儿童陈旧性孟氏骨折的手术治疗. 中华骨科杂志, 2012, 32(5):457-461.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF Ilizarov TECHNIQUE IN TREATMENT OF OLD DISLOCATION OF RADIAL HEAD

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