Rath Narendra Kumar, Carpenter Eleanor Clare, Thomas Daniel Phillip
Department of Paediatric Orthopaedics and Trauma, University Hospital of Wales, Cardiff, UK.
Pediatr Emerg Care. 2011 Dec;27(12):1167-9. doi: 10.1097/PEC.0b013e31823b0186.
Elbow injuries make up to 3% to 4% of all emergency department presentations and are often difficult to diagnose. These injuries are often missed on radiographs because of the large cartilaginous component of the pediatric elbow resulting in malunion. Fractures around the elbow joint are one of the leading causes of litigation claim, and awareness of the pitfalls in diagnosis of these subtle injuries is necessary for a prompt diagnosis. Fracture of the olecranon epiphysis is rare and often being described around puberty and in association with osteogenesis imperfecta. Management using K-wire tension band fixation has been described in the past, which can lead to growth arrest in younger patients.We hereby present a missed rare sleeve-type open olecranon epiphyseal fracture in a young child, highlighting the pitfalls in the diagnosis of these injuries. This article also reviews various options to manage such a rare fracture and also suggests an alternative method of transosseous suture fixation with an excellent result.
肘部损伤占急诊科就诊病例的3%至4%,且常常难以诊断。由于小儿肘部软骨成分较多,这些损伤在X线片上常被漏诊,从而导致畸形愈合。肘关节周围骨折是诉讼索赔的主要原因之一,了解这些细微损伤诊断中的陷阱对于及时诊断至关重要。鹰嘴骨骺骨折很少见,常发生在青春期前后,且与成骨不全有关。过去曾描述过使用克氏针张力带固定的治疗方法,但这可能会导致年轻患者生长停滞。我们在此报告一例小儿漏诊的罕见袖套型开放性鹰嘴骨骺骨折,强调这些损伤诊断中的陷阱。本文还回顾了处理这种罕见骨折的各种方法,并提出了一种经骨缝合固定的替代方法,效果良好。