Hasler C C, von Laer L
Orthopaedic Department, University Children's Hospital Basel, PO Box, Römergasse 8, 4005 Basel, Switzerland.
J Pediatr Orthop B. 2001 Apr;10(2):123-30.
Growth disturbances after fractures of the lateral condyle of the distal humerus in children present mostly as transient stimulation of the lateral physis. Clinically lateral condylar overgrowth leads to a radial bony prominence and varisation of the elbow. From 1974 to 1994, 66 fractures were prospectively diagnosed with standard roentgenograms and treated by open reduction and internal fixation with a metaphyseal lag screw in case of displacement. Fifty-four patients (82%) were reviewed with an average length of follow-up of 10 years (range, 2-22 years) to assess all sequelae of growth disturbances. Screw osteoynthesis led to anatomical union, symmetric carrying angles and full range of motion in all 27 operated cases, and proved to prevent stimulating growth disturbances contrary to the common but relatively unstable fixation with Kirschner wires.
儿童肱骨远端外侧髁骨折后的生长紊乱主要表现为外侧骨骺的短暂刺激。临床上,外侧髁过度生长会导致桡骨骨性突出和肘部内翻。1974年至1994年,通过标准X线片对66例骨折进行前瞻性诊断,对于移位骨折采用切开复位并用干骺端拉力螺钉内固定治疗。对54例患者(82%)进行了随访,平均随访时间为10年(范围2至22年),以评估生长紊乱的所有后遗症。在所有27例手术病例中,螺钉接骨术实现了解剖复位、对称的提携角和全范围活动,并且证明与常用但相对不稳定的克氏针固定相比,能预防刺激性生长紊乱。