Bentounsi Abdelhakim
Acta Orthop Belg. 2015 Sep;81(3):493-500.
Fracture-dislocation of the humeral condyle is exceptional in adults. The purpose was to analyze the results of surgical treatment by open reduction and internal fixation without ligamentous repair. There were six men with an average age of 31 years. According to the AO classification, five fractures were classified as AO type B1 and one as B2. Dislocation was reduced in emergency before osteosynthesis. Postoperatively, the joint was held immobile with a brace for 25.40 days. Five patients were reviewed after a mean follow-up of 52.96 months. The median arc of flexion/extension was 104.80° and 157.8° for pronation-supination. All elbows were stable and all fractures were consolidated. Two elbows were painful. The results were satisfactory in five patients. The elbow stability can be ensured only by the synthesis of bone structures. Surgical treatment should restore exact anatomy between the condyle and trochlea. This protocol may provide a joint stability and satisfactory results.
成人肱骨头髁部骨折脱位较为罕见。目的是分析切开复位内固定且不进行韧带修复的手术治疗效果。研究中有6名男性,平均年龄31岁。根据AO分类,5例骨折为AO B1型,1例为B2型。在进行骨固定之前,先在急诊时进行脱位复位。术后,使用支具将关节固定25至40天。平均随访52.96个月后,对5例患者进行了复查。屈伸活动度的中位数为104.80°,旋前-旋后活动度的中位数为157.8°。所有肘关节均稳定,所有骨折均已愈合。有两个肘关节疼痛。5例患者的治疗结果令人满意。只有通过骨结构的复位才能确保肘关节的稳定性。手术治疗应恢复髁部与滑车之间的精确解剖结构。该方案可提供关节稳定性并取得满意效果。