Our Experiences in Surgical Treatment of Bayne Type III and IV Radial Longitudinal Deficiencies

Öz

Radial longitudinal deficiencies are characterized by radial deviation of the wrist, a short and bowed forearm and a non-functional or absent thumb. The deformity is caused by varying degrees of underdevelopment and malformation including hypoplasia of the bones, joints, muscles, tendons, ligaments, nerves and vessels. This study describes our results from centralization in 8 limbs with Bayne type III-IV radial longitudinal deficiencies. We reviewed 8 limbs from 6 patients with a centralization performed between 2002 and 2010. The median patient age at the time of the operation was 2.75 years (range 2-14 years). The sex ratio was 4 male and 2 female. All patients underwent centralization. One patient had an additional 6.5 cm elongation of the ulna bone by means of a circular external fixator (CEF). The median follow-up time from centralization was 4,5 years (range 2-10 years). The result was considered to be excellent in 4 cases, good in 3 cases and fair in 1 case. Radial deviations regenerated in all cases. During follow-up, a radial deviation of 15 degrees developed in one patient; this deviation did not require surgical correction. Hand and wrist movements were within acceptable levels. Movement and function of the wrist and forearm can be obtained through centralization of the wrist and ulnar elongation when necessary. A cosmetically pleasant appearance can be ensured.

Anahtar Kelimeler

• Radial longitudinal deficiency, centralization, distraction

Our Experiences in Surgical Treatment of Bayne Type III and IV Radial Longitudinal Deficiencies

Öz

Radial uzunluk eksiklikleri elbileğinin radial eğriliği, kısa ve eğri önkol ve eksik veya fonksiyon görmeyen başparmak ile karakterizedir. Deformite kemikler, eklemler, kaslar, tendonlar, ligamentler sinirler ve damarların hipoplazisini içeren malformasyon ve az gelişmenin çeşitli derecelerine neden olur. Bu çalışma, Bayne tip 3 ve 4 radial uzunluk eksiklikliği olan 8 ekstremitedeki santralizasyon sonuçlarımızı tanımlamıştır. 2002 ve 2010 arasında santralizasyon yapılan 6 hastanın 8 ekstremitesi gözden geçirildi. Operasyon zamanında ortalama hasta yaşı 2.75 yıldı (2-14 yıl arası). Cinsiyet oranı 4 erkek, 2 kadın idi. Bütün hastalara centralizasyon yapıldı. Bir hastaya ek olarak ulna kemiğine sirkuler eksternal fiksatör (CEF) vasıtasıyla 6,5 cm uzama sağlandı. Santralizasyon için ortalama takip süresi 4,5 yıldı (2-10 yıl arası). Sonuç 4 olguda mükemmel, 3 olguda iyi, 1 olguda orta kabul edildi. Radial eğrilik tüm olgularda düzeldi. Takip sırasında, bir hastada 15 derece radial eğrilik gelişti; bu eğriliğe cerrahi düzeltme gerekmedi. El ve elbileği hareketleri kabul edilebilir düzeyler içindeydi. Elbileği ve önkol hareket ve fonksiyonu elbileğinin santralizasyonu ve gerektiğinde ulnar uzatma yoluyla elde edilebilir. Kozmetik olarak hoş görünüm sağlanabilir

Anahtar Kelimeler

• Radial uzunluk eksikliği, santralizasyon, uzatma

Kaynakça

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