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儿童肱骨髁上骨折后的神经血管并发症

Neurovascular complications after supracondylar humerus fractures in children.

作者信息

Leiblein Maximilian, Lustenberger Thomas, Schulz Anne-Kathrin, Schmitz-Rixen Thomas, Marzi Ingo

机构信息

Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.

Department of Paediatric Surgery and Paediatric Urology, University Hospital Frankfurt/M., Theodor-Stern-Kai 7, 60590 Frankfurt/M, Germany.

出版信息

Trauma Case Rep. 2017 Jan 6;8:16-19. doi: 10.1016/j.tcr.2017.01.013. eCollection 2017 Apr.

Abstract

BACKGROUND

Supracondylar fractures of the humerus are a common injury in pediatric traumatology. The most common operative therapy is closed reduction and percutaneous pinning using K-wires. Common complications associated with this entity are neurovascular lesions, especially of the brachial artery and the median nerve.

METHODS

We report two cases of patients treated in our trauma-center with supracondylar fracture of the humerus (AO IV°) and neurovascular complications.

RESULTS

Both patients underwent open revision and recovered completely in their further course.

CONCLUSION

We recommend detailed neurovascular examination initially and after reposition of the fracture. The threshold for open reduction in cases of irreducible fractures should be low. In the presence of neurovascular impairment an open revision is mandatory, even months after the initial Trauma.Level of evidence: Level V (case report).

摘要

背景

肱骨髁上骨折是小儿创伤学中的常见损伤。最常见的手术治疗方法是闭合复位并用克氏针经皮固定。与此相关的常见并发症是神经血管损伤,尤其是肱动脉和正中神经损伤。

方法

我们报告了在我们创伤中心治疗的两例肱骨髁上骨折(AO IV°)并伴有神经血管并发症的患者。

结果

两名患者均接受了切开翻修术,术后恢复良好。

结论

我们建议在骨折复位前后均进行详细的神经血管检查。对于难以复位的骨折,切开复位的阈值应较低。如果存在神经血管损伤,即使在初次创伤数月后,也必须进行切开翻修。证据级别:V级(病例报告)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6767/5883211/505c3a26c639/gr1.jpg

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