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两例小儿病例中伴有同侧移位尺骨鹰嘴骨折的移位性外侧髁块骨折的表现及处理

Presentation and Management of Displaced Lateral Condylar Mass Fractures With Ipsilateral Displaced Olecranon Fractures in Two Pediatric Cases.

作者信息

Look Nicole, Erickson Mark, Sibbel Sarah E

机构信息

Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO 80045, United States of America.

Department of Orthopedic Surgery, Children's Hospital Colorado, Aurora, CO 80045, United States of America.

出版信息

Trauma Case Rep. 2020 Jan 11;25:100278. doi: 10.1016/j.tcr.2020.100278. eCollection 2020 Feb.

Abstract

CASES

Two pediatric patients, aged 4 and 6-years-old, presented to a level one children's hospital with displaced lateral condylar mass (LCM) and ipsilateral displaced olecranon fractures after falling directly on to the affected extremity. Both patients underwent surgical fixation of the fractures, one of whom was found to have a laterally dislocated radial head intra-operatively. While one of the patients underwent open reduction internal fixation (ORIF) of both the LCM and olecranon fractures, the other patient underwent ORIF of the LCM and closed reduction percutaneous pinning (CRPP) of the olecranon fracture.

CONCLUSIONS

Both patients were treated immediately upon presentation. They went on to full recovery with well-healed fractures and return of function to the affected extremity. Appropriate surgical management with ORIF versus CRPP may depend on displacement of the fractures and/or involvement of the radial head. Due to the rarity of this fracture combination, it can be difficult to identify in the acute setting. Most complications arise when the LCM-olecranon fractures go untreated. Therefore, it is imperative to have a high suspicion for multiple injuries at the elbow when a pediatric patient presents with elbow pain and swelling after a fall.

摘要

病例

两名儿科患者,年龄分别为4岁和6岁,因直接摔倒在患侧肢体上,导致外侧髁块移位(LCM)和同侧尺骨鹰嘴骨折,被送至一家一级儿童医院。两名患者均接受了骨折的手术固定,其中一名患者在术中发现桡骨头外侧脱位。一名患者接受了LCM和尺骨鹰嘴骨折的切开复位内固定(ORIF),另一名患者接受了LCM的ORIF和尺骨鹰嘴骨折的闭合复位经皮穿针固定(CRPP)。

结论

两名患者均在就诊后立即接受治疗。他们骨折愈合良好,患侧肢体功能恢复,最终完全康复。ORIF与CRPP的适当手术管理可能取决于骨折的移位情况和/或桡骨头的受累情况。由于这种骨折组合罕见,在急性期可能难以识别。当LCM-尺骨鹰嘴骨折未得到治疗时,大多数并发症就会出现。因此,当儿科患者摔倒后出现肘部疼痛和肿胀时,必须高度怀疑肘部存在多处损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d645/6957842/6549717ee320/gr1.jpg

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