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手术治疗儿童陈旧性肱骨外髁骨折14例
Hits: 1929   Download times: 1375   Received:April 13, 2016    
作者Author单位UnitE-Mail
刘凯 LIU Kai 广州市正骨医院, 广东 广州 510000 Guangzhou Orthopaedics Hospital, Guangzhou 510000, Guangdong, China lkaishy@126.com 
尚如国 SHANG Ru-guo 广州市正骨医院, 广东 广州 510000 Guangzhou Orthopaedics Hospital, Guangzhou 510000, Guangdong, China  
肖彦 XIAO Yan 广州市正骨医院, 广东 广州 510000 Guangzhou Orthopaedics Hospital, Guangzhou 510000, Guangdong, China  
胡建炜 HU Jan-wei 广州市正骨医院, 广东 广州 510000 Guangzhou Orthopaedics Hospital, Guangzhou 510000, Guangdong, China  
喻永新 YU Yong-xin 广州市正骨医院, 广东 广州 510000 Guangzhou Orthopaedics Hospital, Guangzhou 510000, Guangdong, China  
期刊信息:《中国骨伤》2017年30卷,第1期,第83-85页
DOI:10.3969/j.issn.1003-0034.2017.01.019


目的:探讨儿童陈旧性肱骨外髁骨折的治疗方法并总结经验。

方法:2012年1月至2014年1月收治儿童陈旧性肱骨外髁骨折14例,均行手术治疗。其中男10例,女4例;年龄2~12岁,平均5.8岁。初步诊断均为MilchⅡ型骨折,其中失治误治11例,保守治疗后骨折移位不愈合3例。轻度肘外翻畸形2例;伸肘障碍10例,受限15°~60°;活动时有疼痛6例。14例患儿损伤至手术时间32~176 d,平均62 d,均行切开复位克氏针内固定术。根据改良An-Morrey肘关节功能评分评价肘关节功能。

结果:14例均获随访,时间1~3年,平均1.8年。无骨折不愈合、畸形愈合、骨骺无菌性坏死、肘内翻或外翻畸形发生,5例有外髁部轻度突起畸形,3例仍有轻度伸直受限。X线片示术后4~8周骨痂生长,关节平面基本恢复,5例有骨刺形成,3例出现骨骺早闭迹象,肱骨外髁增大2例,出现鱼尾样畸形2例。改良An-Morrey肘关节功能评分平均95.2±3.6,优13例,良1例。

结论:对于陈旧性肱骨外髁骨折,手术能有效恢复肘关节外观和功能,近期疗效满意,远期效果有待进一步观察。
[关键词]:肱骨骨折  骨折固定术,内  儿童
 
Surgical treatment for 14 patients with old fractures of humeral lateral condyle in children
Abstract:

Objective: To study clinical effects of operation for the treatment of old fractures of the humerus lateral condyle in children.

Methods: From January 2012 to January 2014 in our department, 14 children of old humeral lateral condyle fractures were treated with operation.Ten cases were male, 4 cases were female;age from 2 to 12 years old, average 5.8 years old.The initial diagnosis was typeⅡfracture according to the Milch ciassification, the loss of treatment in 11 cases, conservative treatment in 3 cases of nonunion after fracture displacement.Two cases had mild cubitus valgus deformity;10 cases had elbow disorders, and the motion range was limited from 15° to 60°;6 cases had pain in activity.The time from injury to operation was 32 to 176 days (62 days on average) in 14 cases, the 14 cases were treated with open reduction and internal fixation.According to the Modified An-Morrey elbow function assessment criteria after surgery for curative effect.

Results: Fourteen cases were followed up for 1 to 3 years, average 1.8 years.No nonunion, malunion, aseptic necrosis of the epiphysis, cubitus varus or valgus occurred.Five cases had mild protrusion deformity of external condyle, 3 cases still had mild dysfunction.The time of clinical bone union was 4 to 8 weeks in X-ray films.Five cases had bony spur formation, 3 cases had signs of early closure of epiphysis;2 cases had a increasing volume of humeral lateral condyle;and 2 cases appeared tail deformity.Modified An-Morrey score averaged (95.2±3.6) points, 13 excellent, 1 good.

Conclusion: For the old fracture of humeral lateral condyle, operation can effectively restore the appearance and function of elbow joint, and the short-term curative effect is satisfactory, but the long-term effect needs further observation.
KEYWORDS:Humeral fractures  Fracture fixation,internal  Child
 
引用本文,请按以下格式著录参考文献:
中文格式:刘凯,尚如国,肖彦,胡建炜,喻永新.手术治疗儿童陈旧性肱骨外髁骨折14例[J].中国骨伤,2017,30(1):83~85
英文格式:LIU Kai,SHANG Ru-guo,XIAO Yan,HU Jan-wei,YU Yong-xin.Surgical treatment for 14 patients with old fractures of humeral lateral condyle in children[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(1):83~85
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