Department of Orthopaedic Surgery, Children's Hospital Colorado, University of Colorado, Aurora, CO.
Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
J Orthop Trauma. 2019 Aug;33 Suppl 8:S17-S21. doi: 10.1097/BOT.0000000000001544.
Pediatric radial neck fractures will inevitably be encountered by the general orthopaedist, and they carry great potential for poor outcomes. Acceptable displacement varies by age, and unlike adults, most of these injuries can be managed by closed means. If they are taken to the operating room, the mainstays of treatment are percutaneous techniques. Increasing patient age, inadequate reduction, unnecessary open reductions, and prolonged immobilization are all associated with worse outcomes, most commonly manifesting as significant elbow stiffness. Knowledge of the age-specific acceptable displacement criteria, a stepwise approach to closed and percutaneous techniques, and safe strategies for open reduction when needed as a last resort will greatly improve treatment success.
儿科桡骨颈骨折不可避免地会被普通骨科医生遇到，且它们具有造成不良预后的巨大风险。可接受的移位因年龄而异，与成人不同的是，这些损伤大多数可通过闭合方式进行治疗。如果将它们送入手术室，治疗的主要方法是经皮技术。患者年龄增加、复位不足、不必要的切开复位和长时间固定都会导致预后更差，最常见的表现是严重的肘部僵硬。了解特定年龄的可接受移位标准、闭合和经皮技术的逐步方法以及在必要时作为最后手段进行切开复位的安全策略，将大大提高治疗成功率。
