Ray Robbie, Gaston Mark
Department of Orthopaedics, Royal Hospital for Sick Children, Edinburgh, UK.
J Pediatr Orthop B. 2014 Sep;23(5):472-6. doi: 10.1097/BPB.0000000000000062.
Radial head dislocation in children is usually associated with complete elbow dislocation or occurs as a part of a Monteggia injury. In patients without an obvious fracture of the ulna, recognizing that plastic deformation of the ulna leads to pathological bowing is a key concept in the management of this injury. Although good results have been published using osteotomy of the ulna to maintain stability after open reduction, we hypothesize that ulnar osteotomy alone may be enough to enable stable enlocation of an irreducible radial head in patients who are identified early. We present two cases of irreducible radial head dislocation, treated with ulnar osteotomy and closed radial head reduction. Both osteotomies united and both patients had an excellent functional outcome with the absence of pain or deformity and early return to function. We explain the surgical technique and compare the outcomes with alternative surgical treatments.
儿童桡骨头脱位通常与肘关节完全脱位相关，或作为孟氏骨折损伤的一部分出现。在没有明显尺骨骨折的患者中，认识到尺骨塑性变形会导致病理性弯曲是处理该损伤的关键概念。尽管已有文献报道在切开复位后采用尺骨截骨术来维持稳定性可取得良好效果，但我们推测，对于早期确诊的患者，单纯尺骨截骨术可能足以实现不可复位桡骨头的稳定复位。我们报告两例不可复位桡骨头脱位病例，采用尺骨截骨术及闭合性桡骨头复位治疗。两处截骨均愈合，两名患者功能恢复极佳，无疼痛或畸形，且能早期恢复功能。我们阐述手术技术，并将结果与其他手术治疗方法进行比较。
