肘内翻与肘外翻

2009-01-14,郑 炜 权,肘内翻与肘外翻,郑炜权,2009-01-14,2009-01-14,肘内翻与肘外翻,肘内翻或肘外翻是由于各种原因引起的肘部畸形。正常肘关节完全伸直时有一轻度外翻，男性约，女性约，这个外翻角称为携带角。若这个角度增大，即前臂过于外展，称为肘外翻畸形；若这个角度减少，甚至成了负角，就叫做肘内翻畸形其病因主要为：(1)肱骨下端骨折畸形愈合(2)由于外伤或感染造成外侧或内侧骨骺生长障碍,2009-01-14,临床表现,主要为肘部外观畸形，常没有症状畸形严重者，可发生迟发性尺神经损伤病程长者，可引起肘关节骨性关节炎本病可发生于任何年龄，但以儿童多见，多以单侧为主，亦可见于双侧本病轻度畸形者，不必作治疗。明显畸形或发生迟发性尺神经损伤，可考虑手术治疗，效果良好,2009-01-14,图1,2009-01-14,fig.1-2: At follow-up. twelve years the patient had a cubitus varus of -20 degrees.,图2,2009-01-14,Fig.3: Cubitus varus deformity of the left elbow 34 months after treatment by closed reduction for a supracondylar fracture.,图3,2009-01-14,Fig.4: Six weeks after Frenchs osteotomy there is good correction of the deformity. Note the periosteal reaction on the medial side of the humerus.,图4,2009-01-14,Fig.5: SUPRACONDYLAR OSTEOTOMY FOR CUBITUS VARUS,图5,2009-01-14,肘外翻,图6,2009-01-14,此图摘自丁香园,图7,2009-01-14,肘外翻,图8,2009-01-14,Fig.8-10: At follow-up. twenty-eight years after injury. the patient had a cuhitus valgus of + 35 degrees.,图10,图9,2009-01-14,图11,2009-01-14,表1 肘关节各角测量值,根据测量前臂外偏角正常为16501700，小于此值为肘外翻，大于此值为肘内翻。亦有以其补角即携带角测量者,2009-01-14,Fig. 12: The upper extremities of a woman, aged fifty-five ears, with cubitus varus of the right elbow as the result of a fracture at time age of five. There is no disturbance of function, but she has always been “sensitive” about its appearance.Fig. 13: Medial tilting of the distal fragment caused by splinting the arm against the trunk (a). This may result in cubitus varus (b).,图13,图12,2009-01-14,Fig.14: Cubitus varus of time right arm, 18 degrees. Normal carryinig angle of the left arm, 15 degrees. Correction necessary, 33 degrees.,图14,2009-01-14,Fig. 15: Result one year afterward. Overcorrectioum about 5 degrees.Fig. 16: A postoperative roentgenogram to illustra