Lam Kai Yet, Mahadev Arjandas
Department of Orthopaedic Surgery, KK Women's and Children's Hospital (KKH), Singapore.
J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019837146. doi: 10.1177/2309499019837146.
Combined lateral condyle mass and olecranon fractures are infrequently seen. These cases are easily missed, and only 12 previous cases are detailed in the English medical literature. The decision for surgical fixation usually depends on the amount of displacement of the individual fractures. However, the optimal surgical approach or technique for open reduction and internal fixation has not been agreed upon. We present three original case reports and analyse them together with all other known cases in the English literature. We discuss how to avoid missing these combined fractures and propose a treatment algorithm based on the different permutations of the fracture displacement. Our detailed surgical approach (using a posterior 'olecranon osteotomy' approach) is also described.
外侧髁块与鹰嘴联合骨折较为少见。这些病例很容易被漏诊，英文医学文献中仅详细报道过12例既往病例。手术固定的决策通常取决于各个骨折的移位程度。然而，对于切开复位内固定的最佳手术入路或技术尚未达成共识。我们呈现3例原始病例报告，并将它们与英文文献中所有其他已知病例一起进行分析。我们讨论了如何避免漏诊这些联合骨折，并根据骨折移位的不同组合提出了一种治疗方案。我们还描述了详细的手术入路（采用后方“鹰嘴截骨”入路）。
