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青少年肱骨小头骨折:6例采用可吸收钉切开复位内固定治疗的研究

Humeral Capitellum Fractures in Adolescents: A Study of 6 Cases Treated by Open Reduction and Internal Fixation with Bioabsorbable Nails.

作者信息

Wiktor Łukasz, Tomaszewski Ryszard

机构信息

Upper Silesian Children's Health Centre, Department of Trauma and Orthopaedic Surgery, Katowice, Poland.

Faculty of Science and Technology, Institute of Biomedical Engineering, University of Silesia in Katowice, Katowice, Poland.

出版信息

Adv Orthop. 2022 Apr 11;2022:4012125. doi: 10.1155/2022/4012125. eCollection 2022.

Abstract

PURPOSE

The purpose of our study was to evaluate the clinical outcome following open reduction and internal fixation of humeral capitellum fractures in adolescents and to assess the usefulness of bioresorbable implants in that procedure. Due to the rarity of these fractures, there are not many studies dealing with the problem in the literature.

METHODS

We retrospectively evaluated a group of 6 skeletally immature patients aged 10.6-15.3 treated at our department from January 2015 to December 2021. Four type I and two type IV were diagnosed based on the Bryan and Morrey classification. Our patients underwent an open reduction and internal fixation of coronal shear fractures with the use of SmartNail®.

RESULTS

All patients were satisfied with the treatment outcome and had full pronation and flexion after surgery. Two patients presented minor deficits of extension and supination compared with the contralateral elbow. At the one-year follow-up, all patients scored 100 on the Mayo Elbow Performance Score.

CONCLUSIONS

Correct diagnosis and early surgical intervention in humeral capitellum fractures are crucial. That fractures should be anatomically reduced with no articular cartilage damage in order to prevent osteoarthritis. Based on our experience, SmartNail® implant is accurate for the osteochondral fragment fixation.

摘要

目的

我们研究的目的是评估青少年肱骨小头骨折切开复位内固定术后的临床疗效,并评估生物可吸收植入物在该手术中的实用性。由于这些骨折较为罕见,文献中处理该问题的研究并不多。

方法

我们回顾性评估了2015年1月至2021年12月在我院接受治疗的一组6例骨骼未成熟患者,年龄在10.6 - 15.3岁之间。根据Bryan和Morrey分类法,诊断出4例I型和2例IV型骨折。我们的患者使用SmartNail®对冠状面剪切骨折进行了切开复位内固定。

结果

所有患者对治疗结果满意,术后均有完全的旋前和屈曲功能。与对侧肘部相比,2例患者的伸展和旋后功能有轻微缺陷。在一年的随访中,所有患者的梅奥肘关节功能评分均为100分。

结论

肱骨小头骨折的正确诊断和早期手术干预至关重要。骨折应解剖复位且不损伤关节软骨,以预防骨关节炎。根据我们的经验,SmartNail®植入物对骨软骨碎片固定准确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba66/9017531/fd6a5fd49315/AORTH2022-4012125.001.jpg

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