From the Department of Orthopedic Surgery, UT Health San Antonio, San Antonio, TX (Mr. Galar, Dr. Ulmer, Dr. Gibbons, Dr. McCormick, and Dr. Landrum); Orthopaedic Surgery, University of Arkansas Medical Sciences, Little Rock, AR (Dr. Landrum).
J Am Acad Orthop Surg Glob Res Rev. 2023 Oct 6;7(10). doi: 10.5435/JAAOSGlobal-D-23-00081. eCollection 2023 Oct 1.
Elbow fractures in the pediatric population are an exceedingly common injury, comprising 5% to 10% of all pediatric fractures, with supracondylar fractures being the most common of the subset. Radial neck fractures are less frequent, comprising only 1% of all pediatric fractures. We provide a case report of a 7-year-old girl with a left radial neck and proximal ulna fracture. A 7-year-old girl presented to the emergency department after falling off a rock wall the day before. Imaging showed a left proximal ulna and proximal radial neck fracture. The patient underwent percutaneous reduction and fixation, complicated by subsequent infection requiring surgical débridement. The patient then developed a recurrent infection 1 year later, requiring repeat irrigation and débridement. The patient has since made a full recovery, returned to activities of daily living, and regained a full range of motion. Radial neck fractures have a low incidence and have been frequently associated with poor outcomes. The main mechanism by which these fractures occur is due to falling on an outstretched arm. Percutaneous pinning is often recommended after unsuccessful attempts at closed reduction because open reduction is often complicated by postoperative stiffness. As with any procedure that involves breaking the skin, there is a risk of infection. However, there is unclear evidence regarding ideal perioperative management to prevent postoperative infection.
儿童肘部骨折是一种非常常见的损伤，占所有儿童骨折的 5%至 10%，其中髁上骨折是最常见的亚型。桡骨颈骨折则较为少见，仅占所有儿童骨折的 1%。我们提供了一例 7 岁女孩左桡骨颈和尺骨近端骨折的病例报告。一名 7 岁女孩前一天从石墙摔下后到急诊科就诊。影像学检查显示左尺骨近端和桡骨颈近端骨折。患者接受了经皮复位和固定，但随后发生感染，需要手术清创。一年后，患者再次发生感染，需要再次冲洗和清创。此后，患者完全康复，恢复了日常生活活动，并恢复了全范围的运动。桡骨颈骨折的发生率较低，且常伴有不良结局。这些骨折发生的主要机制是手臂伸展着地。如果闭合复位不成功，通常建议行经皮穿针固定，因为切开复位常因术后僵硬而变得复杂。与任何涉及皮肤破裂的手术一样，存在感染的风险。然而，对于预防术后感染的理想围手术期管理，目前尚缺乏明确的证据。
