Deptartment of Orthopaedic Surgery & Sports Medicine, Temple University Hospital, Philadephia, PA, USA.
Department of Orthopaedic Surgery, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA.
BMJ Case Rep. 2021 May 27;14(5):e241725. doi: 10.1136/bcr-2021-241725.
Paediatric lateral condyle fractures of the distal humerus are common but a concomitant elbow dislocation is rare. Typically, paediatric orthopaedic surgeons will treat lateral condyle fractures with pin or metaphyseal single-screw fixation and supplementary immobilisation for several weeks. These techniques sacrifice the early stability and mobilisation necessary to avoid stiffness after a complex elbow fracture-dislocation. We present an 11-year-old boy who sustained a traumatic posterolateral elbow dislocation with lateral condyle and coronoid fractures. Due to advanced skeletal age, both paediatric and adult treatment principles were applied to this rare injury. After initial closed reduction, open reduction and internal fixation of the distal humerus lateral condyle with divergent partially threaded compression screws was performed. Motion was initiated in 2 weeks and the patient regained almost full motion by 3 months. At 1.5-year follow-up, the affected limb carrying angle was unaffected and the patient had no functional limitations.
儿童肱骨远端外侧髁骨折较为常见,但伴发肘关节脱位则较为罕见。通常,小儿骨科医生会采用克氏针或干骺端单皮质螺钉固定,并辅以数周的固定,从而治疗外侧髁骨折。这些技术牺牲了早期稳定性和活动度,而这对于避免复杂肘骨折脱位后的僵硬是必要的。我们报告了 1 例 11 岁男孩,他遭受创伤性后外侧肘关节脱位伴外侧髁和冠状突骨折。由于骨骼发育成熟,该罕见损伤同时应用了小儿和成人的治疗原则。在初始闭合复位后,我们采用交叉型部分螺纹加压螺钉对肱骨远端外侧髁进行了切开复位内固定。术后 2 周开始活动,3 个月时患者基本恢复了全部活动度。1.5 年随访时,受累肢体携角无异常,患者无功能受限。