Hansen Matthias, Weltzien A, Blum J, Botterill N J, Rommens P M
Clinic for Trauma-, Hand- and Reconstructive Surgery, City Hospital Worms, Gabriel-von-Seidl-Strasse 81, Worms, Germany.
Arch Orthop Trauma Surg. 2008 Sep;128(9):967-72. doi: 10.1007/s00402-007-0484-7. Epub 2007 Oct 27.
Complete distal humeral epiphysiolysis is a rare and uncommon injury and may result from severe trauma, e.g. birth injury or battered child syndrome.
This is a case report of a 5-month-old female child with distal humeral epiphysiolysis. In the course of clinical and radiological examinations, a battered child syndrome could be diagnosed. Open reduction and temporary transfixation of the distal humeral physis were performed. In the middle term follow-up, 1.5-years after the injury, the function of the elbow was nearly normal but the ulnar condyle showed growth disturbance with cubitus varus of 10 degrees.
Correct diagnosis of complete distal humeral epiphysiolysis may be difficult and misinterpretation of the injury as elbow dislocation should be avoided. This particular lesion is a strong indicator of child abuse. Treatment options and the necessity of operative procedures are discussed.
肱骨远端全骨骺分离是一种罕见的损伤,可能由严重创伤引起,如产伤或受虐儿童综合征。
本文报告一例5个月大患有肱骨远端骨骺分离的女童。在临床和放射学检查过程中,诊断为受虐儿童综合征。对肱骨远端骨骺进行了切开复位和临时固定。在伤后1.5年的中期随访中,肘关节功能接近正常,但尺骨髁出现生长紊乱,伴有10度肘内翻。
肱骨远端全骨骺分离的正确诊断可能困难,应避免将该损伤误诊为肘关节脱位。这种特殊损伤是虐待儿童的有力指征。文中讨论了治疗选择和手术治疗的必要性。