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One-bone forearm for the treatment of supination contractures secondary to neonatal brachial plexus injury.
Rojas-Neira, Juliana; Chaves, Camilo; Díaz-Gallardo, Paula; Nguyen, Trong-Quynh; Dominguez-Amador, Juan J; Soldado, Francisco.
Afiliação
  • Rojas-Neira J; Hand Surgery and Microsurgery Department, Pontificial Javeriana University, Cali, Colombia.
  • Chaves C; Institut de la Main Nantes Atlantique Saint Herblain, France.
  • Díaz-Gallardo P; Pediatric Orthopedic Unit, Hospital Sant pau, Barcelona, Spain.
  • Nguyen TQ; Pediatric Orthopedic Unit, Saint Paul Hospital, Hanoi, Vietnam.
  • Dominguez-Amador JJ; Pediatric Orthopedic Unit, Hospital Puerta del Mar, Cadiz, Spain.
  • Soldado F; Pediatric Hand Surgery and Microsurgery Instituto De Investigación Sanitaria Hm Hospitales (IISHM) HM Nens, Barcelona, Spain.
J Child Orthop ; 18(5): 540-545, 2024 Oct.
Article em En | MEDLINE | ID: mdl-39391577
ABSTRACT

Background:

The one-bone forearm procedure has been considered as a potential treatment for severe forearm deformities. However, its primary limitation lies in the elevated risks of nonunion and infection. In order to enhance union rates, a technical modification was introduced, aiming not only to establish end-to-end radio-ulnar fixation but also to incorporate an additional overlay and fixation between the proximal and distal radius osteotomy stumps. This technique, initially applied in a heterogeneous patient population including individuals with neurological, tumoral, and congenital conditions, yielded promising results, achieving a consolidation rate of 100% and enabling supination corrections of up to 120°.

Methods:

In this study, we present a retrospective cohort of 28 patients, with an average age of 9 years, all afflicted by forearm supination contracture exceeding 90° secondary to neonatal brachial plexus injury. These patients underwent treatment with the modified technique.

Results:

The mean correction achieved in forearm rotation was 116°, and the average follow-up period extended to 43 months. Remarkably, all patients exhibited bone union within an average period of 6.6 weeks, without any complications.

Conclusion:

Our findings underscore the efficacy of this modified technique, which enables substantial rotational corrections, boasts a high union rate, and maintains a low incidence of complications. This approach is particularly valuable for young patients suffering from neonatal brachial plexus injury with severe fixed supination deformities. Case series Level of evidence IV.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Child Orthop Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Child Orthop Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido