de Jager L T, Hoffman E B
Red Cross Children's Hospital, Cape Town, Republic of South Africa.
J Bone Joint Surg Br. 1991 Jan;73(1):143-6. doi: 10.1302/0301-620X.73B1.1991750.
We have reviewed 12 cases of fracture-separation of the distal humeral epiphysis, three of which were initially misdiagnosed as fractures of the lateral condyle and one as an elbow dislocation. Cubitus varus deformity is as common after this fracture-separation as it is following supracondylar fracture, and is most common in children under two years of age. Closed reduction and simple immobilisation is adequate for the older child, but we recommend for those under two years of age that closed reduction should be followed by percutaneous pinning, so that the carrying angle can be assessed immediately after reduction. If the elbow is then in varus the wires should be removed, reduction repeated and treatment by straight lateral traction used to maintain a valgus carrying angle.
我们回顾了12例肱骨远端骨骺骨折分离病例，其中3例最初被误诊为外侧髁骨折，1例被误诊为肘关节脱位。这种骨折分离后肘内翻畸形与髁上骨折后一样常见，且在两岁以下儿童中最为常见。对于年龄较大的儿童，闭合复位和简单固定就足够了，但我们建议对于两岁以下的儿童，闭合复位后应进行经皮穿针固定，以便在复位后立即评估提携角。如果此时肘关节处于内翻位，应取出钢针，重复复位，并采用直外侧牵引治疗以维持外翻提携角。
