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[探讨儿童肘关节损伤致肘内翻的机制]

[Exploring the mechanism of children elbow joint injury led to elbow varus].

作者信息

Zhang De-zhou, Yi Xue-bing, Zhong Jian, Tan Wei, Chen Bing, Chen Yun-jiu

机构信息

Sichuan Province Orthopedic Hospital, Chengdu 610041, Sichuan, China.

出版信息

Zhongguo Gu Shang. 2010 Jan;23(1):39-41.

PMID:20191963
Abstract

OBJECTIVE

To explore the causes and mechanisms of children elbow joint injury led to elbow varus.

METHODS

One hundred children with elbow varus causded by elbow joint injuries were retrospectively studied during January 2005 to April 2008 in department of child orthopedics involving 54 males and 46 females with an average age of 9.7 years old ranging from 7 to 16 years. The anterior-posterior and lateral position X-ray films of elbow joint continuous 12 to 18 months (means 15 months) of all the cases were collected. The postoperative X-ray films were observed to analyze the cause of elbow varus.

RESULTS

There were 81 cases caused by epiphyseal dysplasia, growth imbalance, included 47 cases of humeral supracondylar fractures, 16 cases of entire epiphysis separation of distal humerus, 11 cases of humeral lateral condyle fractures, 7 cases of humeral medial condyle fractures. There were 19 cases caused by ulna drift and rotation of the distal fracture end,the ulnaris cortibal bone crushing and collapse involving 11 of humeral supracondylar fractures, 2 of entire epiphysis separation of distal humerus, 5 of humeral lateral condyle fractures, 1 of humeral medial condyle fractures.

CONCLUSION

There are two main factors of formation for the children elbow varus deformity: the main causes is epiphysial dysplasia after fracture and imbalance growth of epiphysis; the secondary reasons is ulnar inclination of the distal fracture, rotation of the distal fracture, fracture shift such as ulnar bone cortical extrusion collapse.

摘要

目的

探讨儿童肘关节损伤致肘内翻的原因及机制。

方法

回顾性分析2005年1月至2008年4月在儿童骨科就诊的100例因肘关节损伤导致肘内翻的患儿资料,其中男54例,女46例,平均年龄9.7岁,年龄范围7~16岁。收集所有病例术后连续12至18个月(平均15个月)的肘关节正侧位X线片,观察术后X线片分析肘内翻原因。

结果

因骨骺发育异常、生长不平衡导致肘内翻81例,其中肱骨髁上骨折47例,肱骨远端全骨骺分离16例,肱骨外侧髁骨折11例,肱骨内侧髁骨折7例。因尺骨远端骨折端漂移、旋转,尺骨皮质骨挤压塌陷导致肘内翻19例,其中肱骨髁上骨折11例,肱骨远端全骨骺分离2例,肱骨外侧髁骨折5例,肱骨内侧髁骨折1例。

结论

儿童肘内翻畸形形成的主要因素有两个:主要原因是骨折后骨骺发育异常及骨骺生长不平衡;次要原因是骨折远端尺偏、远端骨折旋转、骨折移位如尺骨皮质挤压塌陷等。

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