先天性尺桡骨融合

　　本畸形在一些病人中具有显性遗传，在胚胎发育过程中，尺桡骨均起自中胚层组织，当胚胎第5周时，尺桡骨软骨杆之间不发生分离而骨化或尺桡骨之间填充中胚层组织时则发生尺桡骨融合，第Ⅱ型桡骨小头脱位则发生于胎儿晚期。

　　先天性尺桡骨融合可以并发哪些疾病：

　　本病主要是会产生一些术后并发症，故术后早期应严密观察，警惕出现患肢的缺血性改变，抬高患肢，必要时使用适量脱水剂，对已发生血管危象者应不失时机地切开减压，以挽救患肢并确保其功能，若产生并发症而不及时进行治疗，可并发缺血性肌挛缩和坏死，另外还需注意，因患儿对疼痛耐受强，天生好动，使新生骨痂遭到不断破坏而致内固定物断裂，故宜加强术后保护，必要时用石膏托固定1个月，以期达到Ⅰ期愈合并获得满意的功能。

　　尺桡骨之间无活动性，前臂固定在旋前位，旋后功能丧失，肘关节伸直活动部分受阻，腕关节可自由活动。日常生活影响程度与前臂固定畸形位置有关，如单侧受累，功能影响小。患肢前臂较瘦，外形弯曲。由于桡骨小头发育不全或前、后脱位，正常部位的桡骨小头可见一局部凹陷。本畸形一般分为三型：第Ⅰ型为真正先天性尺桡骨融合，尺桡骨上端融为一起，其中间无皮质骨，桡骨小头与尺骨融合或桡骨小头完全缺如，后者常累及双侧，桡骨干弯曲，比尺骨粗大而长。尺桡骨远端之间一般不发生融合，第Ⅱ型为。第Ⅲ型为尺桡骨之间藉一层骨间韧带连接，阻碍前臂旋转功能，这一型不是真正融合，但临床表现一致。

　　先天性尺桡骨融合应该如何预防：

　　Η νόσος αυτή είναι μια προγεννητική πάθηση χωρίς αποτελεσματικά μέτρα πρόληψης, η νωρίς διάγνωση και θεραπεία είναι η κλειδί για την πρόληψη και την αντιμετώπιση της νόσου. Οι γονείς πρέπει να ενισχύσουν την προσοχή τους στα παιδιά τους καθημερινά, και να οδηγήσουν τα παιδιά τους σε επίσημο νοσοκομείο για εξέταση όταν παρατηρήσουν ότι τα παιδιά τους δεν κινούνται κανονικά ή υπάρχουν δυσλειτουργίες στη στροφή του πρόσθιου μυώματος, για να αποφύγουν την καθυστέρηση της νόσου.

　　The examination of this disease is mainly divided into two types:

　　1Physical examination:There is no mobility between the radius and ulna, the forearm is fixed in the pronated position, the supination function is lost, the extension movement of the elbow joint is partially obstructed, and the wrist joint can move freely.

　　2X-ray imaging:The upper ends of the radius and ulna fuse together, with no cortical bone in between, the radial head fuses with the ulna or the radial head is completely absent; or the radial head is posteriorly dislocated, and the proximal end fuses with the upper part of the ulna shaft.

　　What to eat for congenital fusion of the radius and ulna? Depending on the symptoms, there are different dietary requirements, ask the doctor specifically, and formulate different dietary standards according to the specific disease of the patient.

　　Precautions before the treatment of congenital fusion of the radius and ulna:

　　1To truly assess the degree of deformity in each patient, thereby deciding whether surgery is needed. Generally, it is not recommended to separate the fusion site of the radius and ulna, as the efficacy is often very poor. If the fixed deformity of the pronation of the forearm is severe, exceeding60°, it is possible to perform proximal1/3Excision osteotomy at the site, to keep the forearm in a functional position. Generally, the Kelikian rotation technique can obtain a certain range of rotation of the forearm. The method is the resection of the distal part of the ulna and the transfer of the ulnar flexor tendon to restore the supination function, but the efficacy is sometimes uncertain.

　　2The main symptoms of congenital fusion of the upper radius and ulna are the dysfunction of the forearm rotation. Forearm rotation is a relatively complex movement, the axis of rotation of the forearm is fixed on the ulna, from the center of the radial head to the attachment of the ulna to the cruciate ligament. Along this axis, in the upper radioulnar joint, the radial head rotates around the radial notch of the ulna. The normal pronation of the forearm is approximately80 degrees, supination approximately100 degrees. When pronation or supination decreases by no more than3At 0 degrees, the rotational function will not affect the patient's work and life.