Bandekar Shivanand M, Desai Mihir R
Department of Orthopedic Surgery, Goa Medical College, Bambolim. India.
J Orthop Case Rep. 2015 Oct-Dec;5(4):64-7. doi: 10.13107/jocr.2250-0685.349.
Injuries around the elbow are common in pediatric population. Amongst them, most common is fractures of the supracondylar part of humerus, followed by condylar fractures. Fractures of the neck of the radius account for five-ten percent of the total injuries. Various techniques for closed reduction of the fracture have been described in literature. Open reduction and fixation is indicated when closed reduction fails to provide satisfactory results and the angulation remains more than 45-60 degrees.
We present two cases of severely displaced radial neck fractures treated with closed reduction and intramedullary fixation using titanium elastic nails. The distal bent tip of the nail is used to maneuver the proximal rotated fragment and to reduce it back in its place.
It is an indirect closed reduction technique and associated with minimal intra and post-operative complications and gives encouraging results. It gives stable fixation and also prevents re-displacement after nail removal.
肘部周围损伤在儿童群体中很常见。其中,最常见的是肱骨髁上骨折,其次是髁部骨折。桡骨颈骨折占总损伤的5%至10%。文献中描述了各种骨折闭合复位技术。当闭合复位未能取得满意效果且成角仍大于45至60度时,需进行切开复位内固定。
我们展示两例严重移位的桡骨颈骨折病例,采用钛弹性钉闭合复位和髓内固定治疗。钉子远端的弯曲尖端用于操控近端旋转的骨折块并将其复位。
这是一种间接闭合复位技术,术中及术后并发症极少,效果令人鼓舞。它能提供稳定的固定,还能防止拔钉后再移位。