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肱骨远端外侧闭合楔形截骨导板在儿童肘内翻畸形矫正中的应用

Application of distal humeral lateral closed wedge osteotomy guide in correcting cubeus varus deformity in children
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摘要 目的探讨利用3D打印技术设计肱骨远端外侧闭合楔形截骨导板辅助截骨在儿童肘内翻畸形中应用的可行性。方法回顾性分析正大邵阳骨伤科医院小儿骨科2020年1月至2022年1月共45例采用3D打印外侧闭合楔形截骨导板辅助截骨的肘内翻畸形患儿临床资料。男35例、女10例,左侧24例、右侧21例。测量45例患儿术前、术后提携角,前倾角,肘关节屈伸活动度。采用Oppenheim肘关节功能评分标准评定肘关节功能。结果45例均获随访,术前健侧提携角为(10.64±1.93)°、患侧提携角为(-17.34±2.36)°,末次随访时健侧提携角为(10.82±2.74)°、患侧提携角为(11.29±1.63)°,手术前后患侧提携角对比差异有统计学意义(P<0.05),末次随访时双侧提携角对比差异无统计学意义(P>0.05);末次随访时双侧肘关节活动度对比差异无统计学意义(P>0.05)。根据Oppenheim肘关节功能评分标准,优30例、良12例、差3例,优良率为93%(42/45)。结论3D打印外侧闭合楔形截骨导板辅助截骨,可使肘内翻矫形变得更简便、更精确、创伤更小,并取得较为理想的临床疗效。 Objective To explore the feasibility of utilizing three-dimensional(3D)printing technology for designing a lateral closing wedge osteotomy plate for assisting in osteotomy for cubitus varus deformity in children.Methods Retrospective analysis was conducted for the relevant clinical data of 45 children of cubitus varus deformity treated with the assistance of a 3D printed lateral closing wedge osteotomy plate from January 2020 to January 2022 in the pediatric orthopaedic ward of Chia Tai Shaoyang Orthopedic Hospital.There were 35 boys and 10 girls.The involved side was left(n=24)and right(n=21).Perioperative values of carrying angle,anteversion angle and range of motion of elbow joint were measured.Elbow joint function was assessed by the Oppenheim Elbow Function Score.Results At the last follow-up,carrying angle of affected elbow joint was(11.3±1.6)°.There was no statistically significant difference as compared to unaffected side(P=0.085>0.05).Maximal extension angle of affected limb at the last follow-up ranged from-10°to 15°(average 3.7°)and maximal flexion angle ranged from 125°to 145°(average 134.6°).There was no statistically significant difference as compared to unaffected side(P=0.12>0.05).According to the Oppenheim Elbow Function Score,the excellent/decent rate was 93%.Conclusions For cubitus varus deformity in children,using a 3D printed lateral closing wedge osteotomy plate for assisting in osteotomy may offer a simpler,more accurate and mini-invasive correction,achieving favorable clinical outcomes.
作者 肖黎 孙燕 覃银河 何东 丁绍斌 Xiao Li;Sun Yan;Qin Yinhe;He Dong;Ding Shaobin(Department of Pediatric Orthopedics,Zhengda Shaoyang Traumatology Hospital,Xinshao 422900,China)
出处 《临床小儿外科杂志》 CAS CSCD 北大核心 2024年第5期474-478,共5页 Journal of Clinical Pediatric Surgery
关键词 肘内翻 3D打印 截骨导板 外科手术 儿童 Cubitus Varus 3D Printing Osteotomy Guided Plate Surgical Procedures,Operative Child
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