Leet Arabella I, Young Colby, Hoffer M Mark
Orthopedic Hospital, Los Angeles, California, USA.
J Pediatr Orthop. 2002 Jan-Feb;22(1):2-7.
A retrospective study of 21 medial condylar fractures revealed that the complication rate for these rare fractures was 33%. Most of the minimally displaced fractures healed uneventfully with immobilization; however, one patient developed avascular necrosis of the trochlea, and one patient developed a nonunion. Operative treatment was performed if there was >2 mm of displacement at the fracture site. Two of three fracture-dislocations lost reduction in the early postoperative period, requiring revision with more stable fixation. Medial condylar fractures may be difficult to diagnose in younger children and should be considered when there is a history of trauma and medial-sided elbow pain. Oblique views, arthrography, or magnetic resonance imaging can be helpful in confirming the diagnosis. Management of this rare fracture must include adequate stabilization of the fracture and immobilization until there is radiographic evidence of healing.
一项对21例内侧髁骨折的回顾性研究表明，这些罕见骨折的并发症发生率为33%。大多数轻度移位骨折通过固定顺利愈合；然而，1例患者发生滑车缺血性坏死，1例患者发生骨不连。如果骨折部位移位>2 mm，则进行手术治疗。3例骨折脱位中有2例在术后早期复位丢失，需要采用更稳定的固定进行翻修。内侧髁骨折在年幼儿童中可能难以诊断，当有外伤史和内侧肘部疼痛时应予以考虑。斜位片、关节造影或磁共振成像有助于确诊。这种罕见骨折的处理必须包括对骨折进行充分固定并制动，直至有影像学愈合证据。
