Zhao Xing-Wei, Zhang Li-Qiang, Wang Hong-Jie
Beijing Fengsheng Chinese Traditional Medicinal Traumacologe and Orthopaedic Hospital, Beijing 100034, China.
Zhongguo Gu Shang. 2009 Nov;22(11):868-70.
To study the operation points of manual reduction for treatment of capitellum fractures of type I and analyze the characteristics of fixation with paper splint.
From April 2000 to February 2008, 27 cases with capitellum fractures of type I were treated by manual reduction of 90 degrees bending elbow and external fixation with paper splint, included 23 males and 4 females aged from 5 to 14 years old (means 8.9 years) with the course from 1 to 23 hours (averaged 5.4 hours). Before treatment all the wounded elbows were swollen and malfunctioned, the X-ray film showed that the fracture fragments of capitellum were separated and upside down displaced in varying degrees. During reduction, the correct restoration point was found and the reduction was correct, continuous and steady, and coordinated the passive movement of forearm and elbow joint, and the 90 degrees bending elbow was fixed by paper splint. All the patients were assessed according to JOA elbow joint function assessment method.
All 27 patients were followed-up for from 6 months to 2 years (averaged 17 months). All the elbow joints were painless, the movement and functions were normal, the elbow joints were stable. After reduction, no complication was found. There were 25 cases with the fracture site reaches or nearly reaches healing of anatomical counterparts, only 2 cases with slight cubitus valgus deformity. According to JOA score 25 cases gained 100 scores and 2 cases gained 97 scores.
This method has advantage of strong stability, high success rate, firm and easy fixation, without pressure sore and necrosis.
探讨手法复位治疗Ⅰ型肱骨小头骨折的操作要点，并分析纸夹板固定的特点。
2000年4月至2008年2月，对27例Ⅰ型肱骨小头骨折患者采用屈肘90°手法复位及纸夹板外固定治疗，其中男23例，女4例，年龄5～14岁，平均8.9岁，伤后至就诊时间1～23小时，平均5.4小时。治疗前伤肘均肿胀、功能障碍，X线片显示肱骨小头骨折块分离并不同程度向上移位。复位时找准正确复位点，复位正确、连贯、稳定，同时配合前臂及肘关节的被动活动，屈肘90°后用 纸夹板固定。所有患者均按JOA肘关节功能评定方法进行评定。
27例患者均获随访，时间6个月至2年，平均17个月。所有肘关节均无疼痛，活动及功能正常，肘关节稳定。复位后无并发症发生。骨折部位达到或接近解剖复位愈合者25例，仅2例有轻度肘外翻畸形。按JOA评分，25例获100分，2例获97分。
该方法具有稳定性强、成功率高、固定牢固简便、无压疮及坏死等优点。
