手术治疗的肱骨小头和滑车骨折不愈合。
Nonunion of operatively treated capitellum and trochlear fractures.
作者信息
Brouwer Kim M, Jupiter Jesse B, Ring David
机构信息
Orthopaedic Hand and Upper Extremity Service and Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
出版信息
J Hand Surg Am. 2011 May;36(5):804-7. doi: 10.1016/j.jhsa.2011.01.022. Epub 2011 Mar 23.
PURPOSE
To test the hypothesis that comminuted fractures of the capitellum and trochlea with posterior comminution (Dubberley type 3B) have a greater risk of nonunion than other types of capitellum and trochlea fractures.
METHODS
We observed 30 patients with operatively treated fractures of the capitellum and trochlea for an average of 34 months (range, 12-75 mo). We compared 18 fractures with comminution of the capitellum and trochlea and posterior comminution (type 3B according to Dubberley and colleagues) with 12 fractures consisting of single large anterior fracture fragments with (6 patients; Dubberley type 2B) or without (6 patients; Dubberley type 2A) posterior comminution.
RESULTS
Of 18 patients, 8 with type 3B fractures were noted to have nonunion. No patients with type 2 fractures had a nonunion.
CONCLUSIONS
Fractures of the capitellum and trochlea are prone to nonunion when they create multiple articular fragments and there is posterior comminution (Dubberley type 3B).
目的
验证以下假设，即伴有后方粉碎的肱骨小头和滑车粉碎性骨折（Dubberley 3B型）比其他类型的肱骨小头和滑车骨折发生骨不连的风险更高。
方法
我们观察了30例接受手术治疗的肱骨小头和滑车骨折患者，平均随访34个月（范围12 - 75个月）。我们将18例伴有肱骨小头和滑车粉碎及后方粉碎的骨折（根据Dubberley及其同事的分型为3B型）与12例由单个大的前方骨折块组成的骨折进行比较，其中6例（Dubberley 2B型）或不伴有（6例；Dubberley 2A型）后方粉碎。
结果
18例患者中，8例3B型骨折患者出现骨不连。2型骨折患者均未发生骨不连。
结论
当肱骨小头和滑车骨折产生多个关节面碎片并伴有后方粉碎（Dubberley 3B型）时，易于发生骨不连。
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