El-Sobky Tamer Ahmed, Haleem John Fathy, Sakr Hossam Moussa, Aly Ahmad Saeed
Division of Pediatric Orthopedics, Department of Orthopedic Surgery, Ain-Shams University Faculty of Medicine, Cairo, Egypt.
Department of Radiodiagnosis, Ain-Shams University Faculty of Medicine, Cairo, Egypt.
Clin Orthop Surg. 2017 Dec;9(4):542-546. doi: 10.4055/cios.2017.9.4.542. Epub 2017 Nov 10.
Humeral medial epicondyle fractures constitute around 15% of pediatric elbow fractures. Up to 60% occur in association with elbow dislocations. Knowledge of potential imaging pitfalls when examining acute elbow fractures in children contributes significantly to accurate diagnosis. Nevertheless, management of missed pediatric medial epicondyle fractures has rarely been reported. We present an 11-year-old boy with a neglected and severely displaced medial epicondyle fracture with concurrent ulnar nerve palsy. We performed neural decompression, fragment excision, and muscular and capsuloligamentous reconstruction of the medial elbow. This study demonstrates that the surgical outcome of a late presenting fracture can be satisfactory in terms of function and neural recovery. It also underscores the importance of careful interpretation of elbow imaging including normal anatomic variants.
肱骨内上髁骨折约占小儿肘部骨折的15%。高达60%的病例与肘关节脱位相关。了解小儿急性肘部骨折检查时潜在的影像学陷阱对准确诊断有很大帮助。然而，关于漏诊的小儿内侧髁上骨折的治疗鲜有报道。我们报告一名11岁男孩，患有被忽视的严重移位的内侧髁上骨折并伴有尺神经麻痹。我们进行了神经减压、骨折块切除以及肘部内侧的肌肉和关节囊韧带重建。本研究表明，就功能和神经恢复而言，延迟就诊骨折的手术效果可以令人满意。它还强调了仔细解读肘部影像学（包括正常解剖变异）的重要性。
