Jeevannavar Santosh Somayya, Shenoy Keshav Someshwar, Daddimani Ravi M
Department of Orthopaedics, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
BMJ Case Rep. 2013 May 24;2013:bcr2013009230. doi: 10.1136/bcr-2013-009230.
A 20-year-old woman presented 6 months after an initial injury to her left elbow with pain and restricted movements. She was diagnosed with a type I malunited (Hahn-Steinthal) type of capitellum fracture through radiographic studies. Classically, the treatment has been excision of the fragment, which carries a risk of valgus instability of the elbow and late osteoarthrosis. We report a case of malunited type I capitellum fracture, for which corrective osteotomy through fracture site, open reduction and internal fixation was done 6 months following missed trauma. At 24 months follow-up the capitellum fracture had united and the patient has a stable elbow and excellent range of motion. Our case demonstrates that for type I malunited capitellum fractures corrective osteotomy through fracture site and internal fixation rather than excision of the fragment in young can result in successful union and stable elbow.
一名20岁女性在左肘部初次受伤6个月后出现疼痛和活动受限。通过影像学检查，她被诊断为I型愈合不良（Hahn-Steinthal型）的肱骨小头骨折。传统上，治疗方法是切除骨折块，但这会带来肘部外翻不稳定和晚期骨关节炎的风险。我们报告一例I型肱骨小头骨折愈合不良病例，在漏诊创伤6个月后，通过骨折部位进行了截骨矫形、切开复位内固定。在24个月的随访中，肱骨小头骨折已愈合，患者肘部稳定，活动范围良好。我们的病例表明，对于I型肱骨小头骨折愈合不良，在年轻患者中通过骨折部位进行截骨矫形和内固定而非切除骨折块，可实现成功愈合和肘部稳定。
