Horn B David, Herman Martin J, Crisci Kristin, Pizzutillo Peter D, MacEwen G Dean
St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA.
J Pediatr Orthop. 2002 Jan-Feb;22(1):8-11.
This study investigates the hypothesis that the integrity of the cartilage hinge at the distal humeral epiphysis determines the stability of fractures of the lateral humeral condyle. Sixteen patients with lateral humeral condyle fractures were studied with radiographs and magnetic resonance imaging (MRI). The clinical course of each patient was compared using these imaging studies to determine whether initial fracture displacement and the integrity of the cartilage hinge correlated with fracture stability. Radiographically, 4 fractures were considered unstable (with initial fracture displacement >3 mm) and 12 were stable (initial displacement < or =3 mm). On MRI, 6 fractures were complete (with disruption of the lateral cartilage hinge) and 10 were incomplete. All unstable fractures had complete fractures on MRI. Ten of the 12 patients with radiographically stable injuries had incomplete fractures on MRI. None of these displaced during treatment. Two patients had radiographically stable fractures and complete fractures on MRI. One of these fractures displaced, confirming the hypothesis that the stability of lateral humeral condyle fractures is related to the integrity of the cartilage hinge.
肱骨远端骨骺处软骨铰链的完整性决定肱骨外侧髁骨折的稳定性。对16例肱骨外侧髁骨折患者进行了X线片和磁共振成像（MRI）检查。利用这些影像学检查比较每位患者的临床病程，以确定初始骨折移位和软骨铰链的完整性是否与骨折稳定性相关。在X线片上，4例骨折被认为不稳定（初始骨折移位>3 mm），12例稳定（初始移位≤3 mm）。在MRI上，6例骨折为完全性（外侧软骨铰链中断），10例为不完全性。所有不稳定骨折在MRI上均为完全骨折。12例X线片显示损伤稳定的患者中，10例在MRI上为不完全骨折。这些患者在治疗过程中均未发生移位。2例患者X线片显示骨折稳定，但在MRI上为完全骨折。其中1例骨折发生移位，证实了肱骨外侧髁骨折的稳定性与软骨铰链完整性相关这一假说。
