肱骨内上髁分离骨骺的复位再愈合对肱骨远端形态的影响

Influence of the separated humeral medial epicondylar epiphysis'reduction and healing on the shape of the distal humerus

对经切开复位缝合固定或双克氏针内固定的肱骨内上髁骨骺分离患者进行随访时，随机拍摄了１６人的双肘对比Ｘ线正位片。对１６例患者的双肘Ｘ线正位片进行测量分析表明，分离骨骺被复位后再愈合对肱骨远端形态可产生以下影响：①内外上髁间距增大Ｐ＜０．００１）；②肱骨滑车下关节面连线和肱骨纵轴的内下象限夹角变小（ｐ＜０．００１）；③内上髁高度下降（ｐ＜０．００５）；④内上髁与肱骨滑车内侧端相交处出现尺神经切迹；⑤肘携物角有增大趋势。本文还对这些变化的临床意义及机制进行了探讨。

Folow-up posterio-anterior x-ray plates of both side elbows were taken randomly in 16 patients whose epiphyseal fracture separations of the medial epicondyles of humeruses previously were treated with open mduction and intemal fixation with sutures or Kinchner wires . Measurements of x-ray plates showed that the distance between medial epicondyle and lateral epicondyle was increased (p<0. 001) , the height of raedial epicondyle decreased significantly (p<0.05) , the inferior-medial angle of the humeral middle axle and the tilt of the trochlear joint surface was decreased ( p<0.01), the ulnar sulcus appeared and there was a trend to increase the carrying angle. The mechanism and clinical significance of these deformity were discussed.