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儿童肱骨外侧髁骨折:一种新手术技术的结果

Lateral Humeral Condyle Fracture in Childhood: Results of a New Surgical Technique.

作者信息

Masci Giulia, Basiglini Luca, Giusti Carlotta, Aulisa Angelo Gabriele, Falciglia Francesco

机构信息

U.O.C of Orthopedics and Traumatology, Bambino Gesù Children Hospital, IRCSS (Istituto di Ricovero e Cura a Carattere Scientifico), 00165 Rome, Italy.

Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy.

出版信息

J Clin Med. 2024 May 11;13(10):2830. doi: 10.3390/jcm13102830.

Abstract

Fractures of the lateral condyle of the humerus are one of the most common fractures in children, accounting for between 10% and 20% of fractures involving the elbow, with a peak incidence at 6 years of age. Treatment is often surgical for displaced fractures > 2 mm, according to Milch and Jakob classification. There is no consensus in the literature about the appropriate surgical management of these fractures. : The aim of this study is to describe, propose, and evaluate outcomes and complications of the surgical technique of reduction and osteosynthesis using trans-bone suture with resorbable threads. : Patients with lateral condyle fractures treated with this surgical technique from 2015 to 2019 were included in this retrospective study, with a minimum follow-up of 24 months. For clinical and functional assessment of the elbow, Mayo Elbow Scores were recorded; we assessed the time of fracture healing, carrying angles, and Baumann angle of the affected limb compared to the healthy contralateral elbow for radiographic data. Complications have also been described. : We achieved satisfactory results; 36 patients with lateral condyle fractures were included in this study. Radiological healing was achieved in all cases. There was only one complication. No cases required additional surgical procedures. Almost all patients achieved a complete flexion of 110 degrees or more and complete extension. : This surgical technique has good functional outcomes and fracture healing, a lower incidence of complications when compared to other surgical techniques, and no mechanical failure with good clinical and radiological results.

摘要

肱骨外侧髁骨折是儿童最常见的骨折之一,占肘部骨折的10%至20%,发病高峰年龄为6岁。根据米尔奇(Milch)和雅各布(Jakob)分类法,对于移位超过2毫米的骨折,治疗通常采用手术治疗。关于这些骨折的适当手术管理,文献中尚无共识。本研究的目的是描述、提出并评估使用可吸收线经骨缝合进行复位和骨固定手术技术的结果及并发症。本回顾性研究纳入了2015年至2019年采用该手术技术治疗的外侧髁骨折患者,最小随访时间为24个月。对于肘部的临床和功能评估,记录梅奥肘关节评分;对于影像学数据,我们评估了骨折愈合时间、携带角以及患侧肢体与健康对侧肘部相比的鲍曼角。还描述了并发症情况。我们取得了满意的结果;本研究纳入了36例外侧髁骨折患者。所有病例均实现了放射学愈合。仅出现1例并发症。无需进行额外的手术。几乎所有患者均实现了110度或更大角度的完全屈曲和完全伸展。该手术技术具有良好的功能结果和骨折愈合情况,与其他手术技术相比并发症发生率较低,且无机械故障,临床和放射学结果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdbd/11122216/d8e19ef72a3d/jcm-13-02830-g001.jpg

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