Abstract
Aims: Osteotomy of ulna with fractional distraction maintains ulnar length and reduced position of radial head via interrosseous membrane. Methods: We reviewed 9patients, 5:M, 4:F, aged 2Ð14years. Interval between injury and surgery ranged 2–36months. All had elbow deformity with radial head prominence. Restricted movement in 6patients. 3 had pain on movements. 2x2mm k-wires each, proximal and distal to ulnar osteotomy. Distal k-wires transþxed in radius in supination (during distraction of ulna, radius is pulled down). ÔZñ/ÔTransverseñ osteotomy performed subperiosteally Ulna lengthened by fractional distraction. Axial k-wire in ulna in selected patients to prevent angular deformity, developing at osteotomy site during distraction. Latency period: 7days, Distraction rate: 0.8mm/day. Radial head position monitored by weekly x-rays. Static þxator time: 2x(distraction time), for consolidation of new-bone. Total þxator time: 6weeks followed by þxator removal. Brace for 2weeks with elbow-joint physiotherapy. Results: Distraction corrected ulnar deformity, restored ulnar length and radial head in anatomical position. Average ulnar length gain: 14mm. Duration of distraction: 17days. Average follow-up: 2years (1.5 Ð 4years). We achieved full, painless, stable elbow ßexion, extension, pronation and supination movements in eight but one patient. Pronosupination movement did not deteriorate over four years of study. No patient developed myositis ossiþcans or neurodeþcit. 2patients had minor pin-tract infection, subsided on treatment. Conclusion: Safe, effective and fully controlled method. This technique may be considered before open procedures for radial head.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
