Jakob R, Fowles J V, Rang M, Kassab M T
J Bone Joint Surg Br. 1975 Nov;57(4):430-6.
From an anatomical study and clinical review of fractures of the lateral humeral condyle in children, the following conclusions are drawn. The mechanism of injury is a violent varus force with the elbow in extension, the condyle being avulsed by the lateral ligament and the extensor muscles. If the fracture is incomplete, with an intact hinge of pre-osseous cartilage medially, the fragment will not be displaced. If the fracture is complete the fragment may be displaced, and open reduction with internal fixation is mandatory. The results of open reduction more than three weeks after the fracture are no better than those of no treatment at all, and may kill the lateral condylar fragment by damaging its blood supply. The major problem of a neglected fracture is tardy ulnar nerve palsy; to avoid this, immediate anterior transposition of the nerve is recommended, operation for the fracture itself being of no benefit.
通过对儿童肱骨外侧髁骨折的解剖学研究及临床回顾，得出以下结论。损伤机制为肘关节伸直时的强力内翻暴力，髁被外侧韧带和伸肌撕脱。若骨折不完全，内侧骨前软骨铰链完整，则骨折块不会移位。若骨折完全，骨折块可能移位，此时切开复位内固定是必要的。骨折三周后进行切开复位的效果并不比不治疗好，而且可能因破坏外侧髁骨折块的血供而导致其坏死。漏诊骨折的主要问题是迟发性尺神经麻痹；为避免此情况，建议立即将神经向前移位，而对骨折本身进行手术并无益处。
