儿童肱骨外髁骨折58例治疗分析

Treatment of Humeral Lateral Condyle Fracture in Children

目的探讨儿童肱骨外髁骨折的诊治及并发症的预防。方法对34例Ⅰ型骨折进行非手术治疗28例非手术治疗成功,6例5 15 d发现骨片移位接受手术治疗;11例Ⅱ型骨折,2例非手术治疗成功,9例手术治疗;13例Ⅲ、Ⅳ型骨折和陈旧性骨折病例均手术治疗;58例中共28例手术切开复位内固定治疗。结果非手术治疗的30例中,1例Ⅱ型骨折出现肘内翻;急性、亚急性手术治疗24例中,5例轻度肱骨外髁隆凸,2例轻度肘关节功能受限,1例肱骨小头及滑车坏死;陈旧性骨折手术治疗4例中,2例效果满意,1例肘关节功能受限,1例骨不连。结论儿童肱骨外髁骨折治疗的关键是争取早期解剖复位,防止陈旧性骨折的发生。

Objective To discuss the diagnosis and treatment of humeral lateral condyle fracture in children and the prevention of the complications.Methods A total of 34 patients with type I fracture were managed with conservative therapy,of which 28 were successful and 6 received operation treatment.Among 11 patients with type II fracture,2 received conservative therapy,9 received operation treatment.Thirteen type Ⅲ,type Ⅳ and old fracture cases all received operation treatment.Among these 58 cases,28 were treated with open reduction and internal fixation.Results One type Ⅱpatient managed with conservative treatment had cubitus vars.In 24 patients undergoing emergency operations,the complications of open reduction included the mild protuberance of the lateral condyle in 5 patients,the mild limitation of elbow movement in 2 patients and the osteonecrosis in 1 patient.Two old fracture patients had good outcomes,1 old fracture patient had limitation of elbow movement and 1 had no bone healing.Conclusion The key points of the treatment of humeral lateral condyle fracture in children is early anatomic reduction of the fracture and prevention of occurrence of old fracture.