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成人肱骨远端骨折畸形愈合:一例报告及文献综述

Distal Humerus Fracture Malunion in Adults: A Case Report and a Review of the Literature.

作者信息

Stavrakakis Ioannis M, Ntontis Zisis, Kastritsi Olga, Chaniotakis Constantinos, Alpantaki Kalliopi, Kastanis Grigorios

机构信息

Department of Orthopaedics and Traumatology, Venizeleio and Pananio General Hospital of Heraklion Crete, Greece.

出版信息

Case Rep Orthop. 2022 Apr 29;2022:6041577. doi: 10.1155/2022/6041577. eCollection 2022.

Abstract

INTRODUCTION

Neglected distal humerus fractures are rare injuries, which the orthopaedic surgeon will not deal many times in his career. We present a case of a young patient with such an injury, who was treated with a corrective osteotomy and fixation, resulting in a very good outcome. This case report highlights the importance of surgical intervention for distal humerus fracture malunion. A narrative review of the literature regarding this topic is presented as well. . A 42-year-old female patient presented to our department nine weeks after a displaced distal humerus fracture, which was treated conservatively in another institution. Ulnar nerve neuropathy, pain, and severe stiffness of the elbow were her main symptoms. Open correction of the deformity, anatomical reduction of the articular surface, and realignment of the metaphyseal level of the fracture were performed. Six months postoperation, a painless flexion-extension arc of 110° and a normal rotation of the forearm was achieved.

CONCLUSION

Distal humerus fracture malunion is a challenge. The operation needed for this purpose is much more demanding, and postsurgical complications are more likely to occur as opposed to the treatment of acute fractures. If a proper surgery is performed though, a good clinical outcome can be expected.

摘要

引言

肱骨远端骨折未得到妥善治疗的情况较为罕见,骨科医生在其职业生涯中处理此类骨折的次数不多。我们报告一例年轻患者的此类损伤病例,该患者接受了截骨矫正和内固定治疗,取得了非常好的效果。本病例报告强调了手术干预治疗肱骨远端骨折畸形愈合的重要性。同时还对关于该主题的文献进行了叙述性综述。一名42岁女性患者在肱骨远端骨折移位九周后前来我院就诊,该骨折在另一家机构接受了保守治疗。尺神经病变、疼痛和肘部严重僵硬是她的主要症状。对畸形进行了切开矫正,关节面实现了解剖复位,骨折干骺端水平重新对线。术后六个月,实现了无痛屈伸弧度达110°,前臂旋转正常。

结论

肱骨远端骨折畸形愈合是一项挑战。为此所需的手术要求更高,与急性骨折的治疗相比,术后并发症更易发生。不过,如果进行恰当的手术,可以预期获得良好的临床效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d95/9076338/83652774ba5d/CRIOR2022-6041577.001.jpg

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