forearm varus surgery

It is well known that the internal and external valgus deformities of joints are often corrected by osteotomy. Closed osteotomy causes limb shortening, and open osteotomy can compensate for limb shortening, so the osteotomy method should be selected according to the specific situation. Because the upper limb limb shortening does not exceed 5cm will not cause dysfunction, the main consideration should be to close the osteotomy to facilitate bone healing. If the internal and external valgus deformity of the joint is caused by infection or trauma, the primary disease should be treated actively and effectively. Treatment of diseases: elbow joint rigidity and fibrotic stiffness traumatic elbow arthritis Indication Elbow valgus is often a complication of the supracondylar fracture of the humerus and the external malleolus fracture. The abnormal shape of the elbow joint is not a surgical indication. If the elbow valgus causes delayed ulnar neuritis (the valgus angle is often greater than 35°) An osteotomy of the humerus should be performed. Contraindications The shape of the simple elbow joint is abnormal. Preoperative preparation Taking the X-ray films of the bilateral upper limbs and subtracting the measured valgus angle from the contralateral side is the correction angle required for osteotomy. Surgical procedure Incision and exposure Generally, the posterior incision of the elbow joint is taken from the proximal side of the posterolateral elbow joint of the upper arm about 10 cm, and after extending to the distal end for 13 cm, the fascia is cut into the deep layer, and the triceps triceps are exposed until the olecranon is stopped. The triceps and tibia periosteum were directly cut longitudinally on the distal midline of the humerus, and the subperiosteal dissection revealed the distal end of the humerus. Identify the ulnar nerve. If it is necessary to treat delayed ulnar nerve palsy, the starting point of the forearm flexor muscle group is removed from the upper iliac crest, the ulnar nerve is advanced, and the starting point of the forearm flexor muscle group is reconstructed. 2. Inverted osteotomy A simple transverse osteotomy was performed at the level at which the forearm axis intersected the lateral tibial cortical bone. The distal end of the osteotomy is adducted until the excessive valgus angle is restored to the normal carrying angle, and the degree of correction is controlled and determined by elbow joint elbow X-ray film. When the correction is satisfactory, the osteotomy ends are fixed with two crossed Kirschner wires. complication Crossed Kirschner wire fixation may have ulnar nerve damage. The treatment method can be carefully performed during the operation, and it can also be fixed by inserting two Kirschner wires in parallel from the external iliac crest.

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