Department of Pediatric Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Hepatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
BMC Musculoskelet Disord. 2022 Nov 8;23(1):964. doi: 10.1186/s12891-022-05932-3.
Medial epicondyle fractures are one of the more common humerus fractures, but humeral medial condyle fracture (HMCF) is rare. Nonunion of medial humeral condyle fractures due to functional exercise is less common.
We report a 5-year-old patient with a nonunion HMCF due to excessive functional exercise, who bruised the elbow 1 year ago and had no positive findings on all imaging studies. On this physical examination, there was a snapping and palpable lump in the elbow joint during movement, but the patient did not feel any discomfort and the range of motion of the joint was normal. X rays and computed tomography (CT) showed that the left HMCF was discontinuous, the broken ends were dislocated, and the joint alignment was poor. Open reduction (OR) and screw fixation was used during the operation, and the patient recovered well at 3-month follow-up.
The rarity and low radiographic appearance of displaced HMCF are easily overlooked and can eventually lead to nonunion HMCF, especially when radiographically difficult to visualize before age 5 years. Therefore, regardless of whether there are signs or imaging abnormalities in the growth process of adolescents, they should be vigilant, shorten the time interval for re-examination, and early detection and timely treatment can avoid some complications caused by this.
肱骨内上髁骨折是较为常见的肱骨骨折之一，但肱骨内上髁骨折（HMCF）较为少见。由于功能锻炼导致的肱骨内上髁骨折不愈合则更为少见。
我们报告了一例 5 岁患儿因过度功能锻炼导致的肱骨内上髁骨折不愈合，患儿 1 年前肘部外伤，所有影像学检查均未见阳性发现。此次体格检查时发现肘部活动时有弹响和可触及的包块，但患儿无任何不适感，关节活动度正常。X 线和 CT 显示左侧 HMCF 连续性中断，断端移位，关节对线不良。术中行切开复位（OR）和螺钉固定，术后 3 个月随访时患者恢复良好。
移位的 HMCF 较为罕见，且 X 线表现不明显，容易被忽视，最终可导致 HMCF 不愈合，尤其是在 5 岁以前 X 线较难发现时。因此，无论青少年在生长过程中是否有体征或影像学异常，都应保持警惕，缩短复查时间间隔，早期发现和及时治疗可以避免由此引发的一些并发症。
