摘要目的 介绍治疗先天性桡骨发育不良的初步体会.方法 2006年7月至2008年12月我院收治先天性桡骨发育不良的患儿7例,共8侧(其中一例为双侧累及).男6例,女1例,年龄最小5个月,最大5.5岁,平均2.5岁.除2例为Ⅲ型,其余均为Ⅳ型.此外1例伴发颈椎畸形,1例伴有马蹄足畸形,1例伴有髋关节发育不良.首先采用手法牵拉减缓软组织的挛缩,到1岁时进行手术,手术方法主要是采用尺骨腕关节中置术,即暴露腕关节,于近侧腕骨中心切一小槽,修剪尺骨远端,然后将其插入腕骨小槽中并用克氏针固定,同时对尺侧松弛的组织进行紧缩.在进行该项手术前先要对患儿前臂桡侧挛缩程度进行评估,若桡侧挛缩程度严重,则用ILIZAROV支架牵拉软组织后再行手术.手术后石膏同定4周,术后8周取出克氏针,术后需佩戴矫形支具.随访时间3～30个月,平均12个月.结果 所有患儿在手术后畸形立即得到明显纠正,外观得到明显改善,手术后患肢功能较前也有增进,肘关节活动增多.结论 尺骨腕关节中置术结合桡侧软组织牵拉,术后再辅以矫形支具的佩戴能达到比较满意的治疗效果.

abstractsObjective To review our initial experience in treating the congenital club hand.Methods Between July 2006 and December 2008,7 patients with 8 congenital radial club hands were treated in our hospital.The mean follow-up duration was 12 months(3 to 30months).The mean age of the patients was 30 months(5 to 66 months).Except for 2 Bayne type Ⅲ radial club hands,the remaining patients were of type Ⅳ.According to the age and the contracture of the soft tissue,a staged protocol consisting of passive stretch of the soft tissue or gradual distraction with Ilizarov external fixator followed by centralization of the ulna were carried out.Results The appearance and the function of the hands improved after the operations.The elbows also had a wider range of movement than before.Conclusions Early soft tissue stretch followed by centralization of the ulm using a splint post-operatively could achieve satisfactory results.