Fuad M, Elmhiregh A, Motazedian A, Bakdach M
Orthopedic Department, Alwakra Hospital, Al Wakra, Qatar.
Orthopedic Department, Alwakra Hospital, Al Wakra, Qatar.
Int J Surg Case Rep. 2017;36:103-107. doi: 10.1016/j.ijscr.2017.04.026. Epub 2017 May 15.
Isolated capitellar fracture is a rare injury accounting for 1% of all elbow fractures Bryan and Morrey (1985) and Poynton et al. (1998). In children, a fall on an outstretched hand, before the fusion of the epiphysis, usually leads to lateral condyle physeal fractures. Very few cases of capitellar fractures in the paediatric population have been reported.
Our patient, a 9-year-old girl presented with a capitellar fracture and lateral collateral ligament (LCL) avulsion of her left elbow. A type IV capitellar fracture, indicated by the double arc sign on the radiogram, was confirmed with 3-dimensional computed tomography. The patient underwent open reduction through a lateral approach and fixation with 2 Herbert's screws. The lateral collateral ligament (LCL) avulsion was repaired with 2 suture anchors. Early mobilization and rehabilitation were started soon after the surgery. Follow-up radiography showed union of the fracture with no signs of osteonecrosis.
Capitellum fracture in children is easily overlooked due to its rarity. And hereby, meticulous history, clinical examination and proper radiological views with high index of suspicion is crucial in order diagnose these injuries. Our patient had type IV capitellar fracture with lateral collateral ligament avulsion. Principles of management of these intra articular fractures include accurate reduction, stable fixation and early mobilization. We used an extensile lateral approach to expose, reduce and fix the fracture. LCL avulsion was fixed with 2 suture anchors.
Capitellum fractures are rare injuries in children. Careful evaluation and proper stable fixation are the cornerstones of good functional results.
单纯的肱骨小头骨折是一种罕见的损伤，占所有肘部骨折的1%（布莱恩和莫里，1985年；波因顿等人，1998年）。在儿童中，骨骺融合前伸直手摔倒通常会导致外侧髁骨骺骨折。儿科人群中肱骨小头骨折的病例报道极少。
我们的患者是一名9岁女孩，因左肘部肱骨小头骨折和外侧副韧带撕脱前来就诊。X线片上的双弧征提示为IV型肱骨小头骨折，三维计算机断层扫描得以证实。患者通过外侧入路进行切开复位，并用2枚赫伯特螺钉固定。外侧副韧带撕脱用2枚缝合锚钉修复。术后不久即开始早期活动和康复治疗。随访X线片显示骨折愈合，无骨坏死迹象。
儿童肱骨小头骨折因其罕见性容易被忽视。因此，详细的病史、临床检查以及高度怀疑下的正确影像学检查对于诊断这些损伤至关重要。我们的患者为IV型肱骨小头骨折合并外侧副韧带撕脱。这些关节内骨折的治疗原则包括精确复位、稳定固定和早期活动。我们采用扩大外侧入路来显露、复位和固定骨折。外侧副韧带撕脱用2枚缝合锚钉固定。
肱骨小头骨折在儿童中较为罕见。仔细评估和恰当的稳定固定是获得良好功能结果的基石。
