Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA.
J Am Acad Orthop Surg. 2011 Jun;19(6):350-8. doi: 10.5435/00124635-201106000-00005.
Lateral condylar fractures constitute 12% to 20% of all pediatric distal humerus fractures. These fractures are easily missed and when not managed appropriately can displace. Missed fracture is a common cause of nonunion and deformity; thus, a high index of suspicion and adequate clinical and radiographic evaluation are required. Displaced fractures are associated with a high rate of nonunion. Nondisplaced fractures or those displaced ≤2 mm are managed with cast immobilization and frequent radiographic follow-up. Fractures displaced >2 mm are managed with surgical fixation. Successful outcomes have been reported with closed reduction, open reduction, and arthroscopically assisted techniques. Complications associated with pediatric lateral condylar fracture include cubitus varus, cubitus valgus, fishtail deformity, and tardy ulnar nerve palsy.
外侧髁骨折占所有小儿肱骨远端骨折的 12%至 20%。这些骨折很容易漏诊,如果处理不当,可能会移位。漏诊是骨折不愈合和畸形的常见原因;因此,需要高度怀疑和充分的临床和影像学评估。移位的骨折与高不愈合率有关。无移位或仅移位≤2 毫米的骨折采用石膏固定和频繁的影像学随访治疗。移位>2 毫米的骨折采用手术固定。闭合复位、切开复位和关节镜辅助技术均有报道取得了良好的效果。小儿外侧髁骨折相关的并发症包括肘内翻、肘外翻、鱼尾状畸形和迟发性尺神经麻痹。