Enishi T, Matsuura T, Suzue N, Sairyo K
Department of Rehabilitation Medicine, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
Trauma Case Rep. 2015 Jun 16;1(1-2):9-12. doi: 10.1016/j.tcr.2015.03.001. eCollection 2015 Feb.
A persistent olecranon physis is relatively rare; a fracture through the persistent olecranon physis in an adult is particularly rare. Little is known about the pathology of this disease. We report a case of a 36-year-old man presenting with right elbow pain after he had slipped and hit his elbow, with a history of a persistent symptomatic olecranon physis when he was a junior high school baseball player. He had been diagnosed with a fracture through a persistent olecranon physis by another doctor. Ten weeks after the injury, an iliac autograft was inserted and internal fixation was achieved with Kirschner wires and a figure-of-eight tension band in our hospital. Histologically, a fracture passed through the persistent physis cartilage and degeneration of the remnant of the physis was observed. The remnant of the physis at the olecranon side had not been replaced by new bone, though the physis at the distal ulnar was nearly replaced by new bone. The patient returned to work without experiencing pain or limitation in the range of motion 6 months after the operation. Radiographic evidence of bone union was seen after removal of internal fixation at the 13-month follow-up.
持续存在的鹰嘴骨骺相对少见;成人通过持续存在的鹰嘴骨骺发生骨折则尤为罕见。关于这种疾病的病理情况知之甚少。我们报告一例36岁男性病例,他滑倒时肘部受伤后出现右肘疼痛,其初中时作为棒球运动员时有持续存在的有症状的鹰嘴骨骺病史。另一位医生诊断其为通过持续存在的鹰嘴骨骺发生的骨折。受伤10周后,我院为其植入髂骨自体骨,并使用克氏针和8字张力带进行内固定。组织学检查发现,骨折穿过持续存在的骨骺软骨,且观察到骨骺残余部分发生退变。鹰嘴侧的骨骺残余未被新骨替代,而尺骨远端的骨骺几乎已被新骨替代。术后6个月,患者恢复工作,未出现疼痛或活动范围受限的情况。在13个月随访时取出内固定后可见骨愈合的影像学证据。