Fernandez F F, Eberhardt O, Langendörfer M, Wirth T
Department of Orthopaedics, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany.
Injury. 2008 Dec;39(12):1453-9. doi: 10.1016/j.injury.2008.04.001. Epub 2008 Jul 25.
We report our experience of elastic stable intramedullary nailing (ESIN) of severely displaced proximal humeral fracture Type III and IV according to Neer in children. Thirty-five children (mean age 12.7 years) with 19 Salter-Harris Type II epiphyseal fractures and 16 children with metaphyseal fractures of the proximal humerus were treated with ESIN by one-nail or two-nail-technique. There were the following complications: two perforations of the nail at the head of the humerus with loss of position, one loss of position without nail perforation, one misplacement of a nail, one revision due to haematoma and two difficult removals of metal. For follow-up examinations after 26 months the children were classified by use of the Constant-Murley score. On average they gained 99 points. All children were able to resume their sporting activities as before. For the treatment of displaced proximal humeral fractures in children more than 10 years old the retrograde ESIN represents a safe minimal invasive surgical procedure.
我们报告了根据Neer分类法，采用弹性稳定髓内钉固定术（ESIN）治疗儿童III型和IV型严重移位肱骨近端骨折的经验。35例儿童（平均年龄12.7岁），其中19例为Salter-Harris II型骨骺骨折，16例为肱骨近端干骺端骨折，采用单钉或双钉技术行ESIN治疗。出现了以下并发症：2例肱骨头部钉穿孔伴位置丢失，1例无钉穿孔的位置丢失，1例钉移位，1例因血肿行翻修术，2例金属取出困难。随访26个月后，采用Constant-Murley评分对儿童进行分类。他们平均获得99分。所有儿童均能像以前一样恢复体育活动。对于10岁以上儿童移位肱骨近端骨折的治疗，逆行ESIN是一种安全的微创手术。
