Unilateral External Fixator In The Treatment Of Shortening Deformity After Distal Ulnar And Radial Fractures In Children

Objective: To explore the clinical efficacy of bone lengthening with unilateral external fixator in the treatment of shortening deformity after distal ulnar and radial fractures in children.Methods: Totally 18 cases of children patients with shortening deformity after fracture of the distal ulna and radius treated in our hospital from September 2006 to March 2016 were included into this study,with 17 cases of radial shortening and 1 case of ulnar shortening.All the children patients were treated with Orthofix unilateral external fixator,and the shortening deformity were extended by adjusting external stent after operation.The appearance and function of the children patients were followed-up in 15-36 months post-operation,and the clinical efficacy was evaluated using Gartland and Werley wrist scores.Results: In all 18 cases of children patients,there were 3 cases occurred axial offset,but the butt joint line of osteotomy position recoveredafter adjusting the external fixator,the pin tract infection occurred in 4cases,but the infection was controlled by changing dressings and locally external use of antibiotics;there were 17 cases occurred bone healing of osteotomy position after operation,bone ununion occurred in 1 case,which was bone healed after autologous bone marrow transplantation.No neurovascular injury and refracture were observed in all the children patients.The correction effect of sequel shortening deformity in all 18 cases of children patients was good,the last follow-up results showed that,the wrist dorsal extension increased to 53.50±6.02° from preoperative45.39 ± 5.56 °,the wrist flexion increased to 55.00 ± 10.71 ° from preoperative 49.83±4.08°.The forearm pronation increased to 78.89±7.04 ° from preoperative 73.78 ± 5.33 °,and the forearm supination increased to 75.44 ± 5.19 ° from preoperative 73.61 ± 5.01 °.The differences in shortening length,forearm pronation,forearm supination,wrist dorsal extension and flexion angel between before and after operation were statistically significant(P<0.01).The evaluation results of Gartland and Werley wrist scores indicated excellent in 3 cases,good in 13 cases,medium in 1 case and poor in 1 case,and the difference was statistically significant.Conclusion: For the children patients with sequel shortening deformity after fracture of the distal ulna and radius,the forearm deformity and wrist function could be significantly improved by lengthening withunilateral external fixator,thereby improving their quality of life,which is worth further application in the clinic.