Masada K, Kawai H, Kawabata H, Masatomi T, Tsuyuguchi Y, Yamamoto K
Department of Orthopaedic Surgery, Osaka University Medical School, Japan.
J Bone Joint Surg Am. 1990 Jan;72(1):32-40.
In thirty elbows that had an established non-union of a fracture of the lateral humeral condyle that had occurred more than five years before, treatment consisted of one of three operations: anterior transposition of the ulnar nerve (nine patients), corrective osteotomy of the humerus and anterior transposition of the ulnar nerve (four patients), or osteosynthesis of the non-union combined with neurolysis and anterior transposition of the ulnar nerve, with or without corrective osteotomy of the humerus (seventeen patients). Of the thirty patients, fifteen had been apprehensive when using the elbow, due to lateral instability, or had had pain in the elbow. In thirteen of these fifteen patients, the non-union was treated by osteosynthesis. Afterward, the pain and apprehension disappeared, but the range of motion of the elbow decreased in all but three patients. Three patients had clicking between the humerus and radius, and the bone failed to unite in three others. Osteosynthesis is indicated for the treatment of non-union of the lateral humeral condyle only if the patient has serious pain in the elbow or apprehension when using the elbow, due to lateral instability.
在30例肱骨外侧髁骨折已形成骨不连且时间超过5年的肘部病例中，治疗方法包括以下三种手术之一：尺神经前置术（9例患者）、肱骨矫正截骨术加尺神经前置术（4例患者）、骨不连的接骨术联合神经松解术及尺神经前置术，肱骨是否进行矫正截骨术视情况而定（17例患者）。在这30例患者中，15例患者因外侧不稳定在使用肘部时感到担忧，或肘部疼痛。在这15例患者中的13例，骨不连采用接骨术治疗。术后，疼痛和担忧消失，但除3例患者外，所有患者的肘部活动范围均减小。3例患者肱骨与桡骨之间有弹响，另有3例骨未能愈合。仅当患者因外侧不稳定在肘部有严重疼痛或使用肘部时感到担忧时，才建议采用接骨术治疗肱骨外侧髁骨不连。
