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肱骨髁上骨折伴发的动脉损伤。

Arterial damage accompanying supracondylar fractures of the humerus.

作者信息

Mohammadzadeh Mohammad Ali, Mohammadzadeh Maryam, Mohammadzadeh Ali, Herfatkar Rasoul, Mohammadzadeh Vahid, Baghi Iraj, Heydari Hamid, Najafi Sona, Jalili Michael

机构信息

Department of Surgery, Gilan University of Medical Science, Rasht, IR Iran.

Imam Khomeini Hospital, Tehran University of Medical Science, Tehran, IR Iran.

出版信息

Trauma Mon. 2012 Jan;16(4):160-3. doi: 10.5812/kowsar.22517464.3273. Epub 2012 Jan 15.

Abstract

BACKGROUND

Arterial damage is sometimes associated with supracondylar fractures of the humerus. Diagnosis and careful management of the fracture and arterial repair is crucial.

OBJECTIVES

The aim of this study was to determine the prevalence and outcome of supracondylar fractures of the humerus with signs and symptoms of limb ischemia, before and after arterial decompression or arterial reconstruction.

MATERIALS AND METHODS

From September 2004 to July 2010, 225 consecutive patients with supracondylar fracture of the humerus were prospectively recruited.

RESULTS

From among 75 cases with Gartland type III fractures, 22 were found to have vascular injury.. Of the 22 cases with vascular injury, 7 patients underwent arterial reconstruction. The other 15 received arterial decompression. All patients had a satisfactory outcome.

CONCLUSIONS

A high level of suspicion and careful clinical evaluation leading to an early diagnosis and management of vascular injury accompanying supracondylar fracture is very important to prevent unnecessary sequelae ranging from limb claudication, and compartment syndrome to more severe complications like Volkmann's contracture and even limb loss.

摘要

背景

动脉损伤有时与肱骨髁上骨折相关。骨折的诊断及仔细处理以及动脉修复至关重要。

目的

本研究的目的是确定在进行动脉减压或动脉重建前后,伴有肢体缺血体征和症状的肱骨髁上骨折的患病率及治疗结果。

材料与方法

2004年9月至2010年7月,前瞻性纳入了225例连续的肱骨髁上骨折患者。

结果

在75例Gartland III型骨折病例中,发现22例存在血管损伤。在这22例血管损伤病例中,7例患者接受了动脉重建。另外15例接受了动脉减压。所有患者均获得了满意的结果。

结论

高度怀疑并进行仔细的临床评估,从而早期诊断并处理肱骨髁上骨折伴发的血管损伤,对于预防从肢体间歇性跛行、骨筋膜室综合征到更严重的并发症如Volkmann挛缩甚至肢体缺失等不必要的后遗症非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f041/3989565/f282cd64bfc9/traumamon-16-160-g001.jpg

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