Yoo C I, Suh J T, Suh K T, Kim Y J, Kim H T, Kim Y H
Department of Orthopaedic Surgery, College of Medicine, Pusan National University, Korea.
Orthopedics. 1992 Aug;15(8):959-63. doi: 10.3928/0147-7447-19920801-16.
Fracture-separation of the distal end of the humerus in children has been reported infrequently, and may be misdiagnosed as a fracture of the condyle or a traumatic dislocation of the elbow. We discuss eight cases of a seldom reported complication following fracture-separation of the distal end of the humerus. This complication consists of dissolution of the trochlea within three to six weeks postinjury and a defect of the medial or central part of the condyle that develops later. The fractures were severely displaced fracture-separation of the distal end of the humerus with large medial or lateral metaphyseal fragment, but initially misdiagnosed as a fracture of the medial, lateral condyle or a traumatic dislocation of the elbow in six of eight cases. We performed open reduction in six cases because of initial misdiagnosis or because of difficulty in satisfactory closed reduction. We speculated that this complication is due to avascular necrosis of the distal end of the humerus, and that fracture-separation of the distal end of the humerus is more common than reported.
儿童肱骨远端骨折分离的报道较少，且可能被误诊为髁部骨折或肘部创伤性脱位。我们讨论了8例肱骨远端骨折分离后一种罕见报道的并发症。该并发症包括伤后三至六周滑车溶解，以及随后出现的髁部内侧或中央部分缺损。骨折为肱骨远端严重移位的骨折分离，伴有大的内侧或外侧干骺端碎片，但8例中有6例最初被误诊为内侧、外侧髁骨折或肘部创伤性脱位。由于最初的误诊或难以实现满意的闭合复位，我们对6例进行了切开复位。我们推测这种并发症是由于肱骨远端缺血性坏死所致，而且肱骨远端骨折分离比报道的更为常见。
