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目的探讨尺骨远端遗传性多发性骨软骨瘤病的病变特点和治疗效果。方法回顾性地分析了14例23侧累及尺骨远端的多发性骨软骨瘤病例,有2侧采用非手术治疗,5侧接受了瘤体切除手术,17侧接受了尺骨延长术,5侧接受了桡骨截骨术。比较了手术前后的前臂功能和外观变化。并对桡骨头脱位和尺骨弯曲的相关性进行了统计学分析。结果本组病例术后前臂短缩、弯曲和时关节畸形改善较为明显。部分病例切除部分瘤体后,使尺骨远端的部分骺板开放。在尺骨延长后,部分病例桡骨远端的尺偏角也显著减少。但肘、腕关节主动屈、伸活动度、前臂旋前、旋后活动度、以及握力在术前和术后的测量值差异均无显著性意义。手术也不能使脱位的桡骨头良好复位。在桡骨头脱位的病例中,尺骨弯曲度为24．2°±7．5°,在没有桡骨头脱位的病例中,尺骨的弯曲度为6．5°±5．1°,两者差异有非常显著性意义。结论桡骨头脱位和尺骨弯曲有密切的相关性,手术治疗对外观改善较为明显,但无助于患肢功能改善,应依据病变的具体情况制定个性化的手术方案,如果决定采用手术治疗,早期手术疗效更好。
Objective To investigate the pathological features and therapeutic effects of hereditary multiple osteochondromatosis in the distal ulna. Methods A retrospective analysis of 14 cases of multiple osteochondroma involving the distal ulna in 23 sides was performed on two sides with non-surgical treatment, 5 cases underwent tumor excision, 17 cases received ulnar elongation and 5 received Radial osteotomy. The changes of forearm function and appearance before and after surgery were compared. The correlation between radial head dislocation and ulnar curvature was analyzed statistically. Results In this group of patients, forearm shortening, flexion and joint deformity improved more obviously. Part of the excision of some cases of tumor, the distal part of the ulna to open the epiphyseal plate. In the ulna extended, in some cases the distal radius ulnar deviation was also significantly reduced. But elbow, wrist flexion and extension activities, forearm pronation, supination activity, and grip strength in the preoperative and postoperative measurements were no significant difference. Surgery can not make a good reset dislocation of the radial head. In the case of dislocation of the radial head, the ulnar curvature was 24.2 ° ± 7.5 °. In the absence of radial head dislocation, the flexion of the ulna was 6.5 ° ± 5.1 °, with a difference of Very significant. Conclusions Radial head dislocation is closely related to ulnar curvature. Surgical treatment is more effective in improving appearance, but it does not help to improve the function of limbs. Therefore, we should formulate a personalized surgical plan according to the specific conditions of the lesion. If it is decided to use surgical treatment, Surgical efficacy better.