Shen Pinquan, Zhang Jing, Chen Ting
Department of Orthopaedics, Wenzhou Medical College, Wenzhou Zhejiang, 325035, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007 Mar;21(3):266-8.
To analyze the treatment of old united lateral condyle fractures of humerus in children.
From January 1997 to February 2002, 13 cases of old united lateral condyle fractures of humerus were treated. There were 11 boys and 2 girls. Their age was from 4 to 11 years (7.2 years on average). The primary diagnosis results were 4 cases of degree I fracture, 5 cases of degree II fracture and 4 indefinitely diagnosed cases. Elbow extension disorder occurred in 13 cases, which was limited 30-70. The elbow flexion was limited more than 90 degrees. X-ray films showed 10 nonunion and 3 malunion of fracture. The time from injury to operation was 32 to 81 days (56 days on average) in 12 cases and 6 months in 1 case. All cases were treated by open reduction and internal fixation. One case was treated combined with implanting bone.
After a follow-up of 3 to 8 years (5.4 years on average), no cubitus varus or valgus occurred. Five cases had growth disturbances of the lateral condyle of the distal humerus. The movement of these elbow joints improved from 40 degrees to 70 degrees (56 degrees on average). The time of clinical bone union was 6 to 8 weeks and no nonunion and delayed union were observed in X-ray films.
It is important to accurately diagnose for treatment of lateral condyle fractures of the humerus in children so as to reduce the occurrence of malunion of fracture. It can save the joint function and reduce the cosmetic deformity effectively to operate as early as possible.
分析儿童陈旧性肱骨外侧髁骨折的治疗方法。
1997年1月至2002年2月，治疗13例陈旧性肱骨外侧髁骨折患儿。其中男11例，女2例。年龄4～11岁，平均7.2岁。初诊结果为Ⅰ度骨折4例，Ⅱ度骨折5例，诊断不明确4例。13例均有伸肘障碍，伸肘受限30°～70°。屈肘受限均超过90°。X线片显示骨折不愈合10例，畸形愈合3例。12例伤后至手术时间为32～81天，平均56天；1例为伤后6个月。均采用切开复位内固定治疗，1例同时植骨。
随访3～8年，平均5.4年，无肘内翻或肘外翻发生。5例肱骨远端外侧髁有生长障碍。肘关节活动度由术前平均40°改善至术后平均70°（平均56°）。临床骨愈合时间为6～8周，X线片未发现骨折不愈合及延迟愈合。
准确诊断对儿童肱骨外侧髁骨折的治疗非常重要，以减少骨折畸形愈合的发生。尽早手术可有效挽救关节功能，减少外观畸形。
