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采用改良梅泰佐技术治疗的移位型杰弗里2型桡骨颈骨折:1例病例报告

Displaced Jeffery Type 2 Radial Neck Fracture Managed by a Modified Métaizeau Technique: A Case Report.

作者信息

Dharmshaktu Ganesh Singh, Dharmshaktu Ishwar Singh, Yadav Krishna Dev Singh

机构信息

Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India.

出版信息

J Orthop Case Rep. 2024 Dec;14(12):197-201. doi: 10.13107/jocr.2024.v14.i12.5072.

DOI:10.13107/jocr.2024.v14.i12.5072
PMID:39669047
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11632495/
Abstract

INTRODUCTION

The radial neck fractures in children are uncommon injures and more so in the settings of an associated elbow dislocation. Radial neck fracture, with 90° posterior rotation of the articular surface with respect to its normal axis, is a characteristic feature of rare Jeffery type 2 injury. This injury pattern is reported as sporadic reports or small series in the literature. Most of the reported cases have been managed by operative intervention with either open or percutaneous reduction and K-wire fixation. Despite the fact that isolated radial neck fractures have been managed frequently by the retrograde intra-medullary wire fixation technique as described by Métaizeau, its modified utilization as standalone treatment has rarely been described for Jeffery type 2 injury, to the best knowledge of the authors.

CASE REPORT

We, hereby report our experience of a displaced Jeffery type 2 radial neck fracture, associated with the posterior elbow subluxation in a 13-year-old male. The injury was finally treated with open relocation of the displaced radial head to the radius neck followed by retrograde fixation of the radial head with one retrograde intramedullary K-wire as a modified Métaizeau technique. Gradual healing of the fracture, stable elbow, and painless activities of daily living were noted along with normal regain of pre-injury elbow function. No complication or instability was noted and excellent Mayo Elbow performance score in the follow-up of 13 months.

CONCLUSION

The peculiar injury pattern of Jeffery type 2 radial neck fracture warrants early recognition and appropriate management for the optimal functional outcome and also to avoid complication. Open reduction of the displaced radial head and fixation with Métaizeau technique is viable option for the management of this rare injury.

摘要

引言

儿童桡骨颈骨折并不常见,合并肘关节脱位时则更为少见。桡骨颈骨折,关节面相对于其正常轴线向后旋转90°,是罕见的杰弗里2型损伤的特征性表现。这种损伤模式在文献中多为零星报道或小样本系列研究。大多数报道的病例采用手术干预,包括切开复位或经皮复位及克氏针固定。尽管孤立性桡骨颈骨折常采用梅塔佐描述的逆行髓内针固定技术进行治疗,但据作者所知,其改良后作为杰弗里2型损伤的单一治疗方法却鲜有报道。

病例报告

在此,我们报告1例13岁男性患者,其发生移位的杰弗里2型桡骨颈骨折并伴有肘关节后脱位的治疗经验。最终通过将移位的桡骨头开放复位至桡骨颈,然后采用一枚逆行髓内克氏针进行桡骨头逆行固定,作为改良的梅塔佐技术。骨折逐渐愈合,肘关节稳定,日常生活活动无痛,伤前肘关节功能正常恢复。随访13个月,未发现并发症或不稳定情况,梅奥肘关节功能评分优秀。

结论

杰弗里2型桡骨颈骨折独特的损伤模式需要早期识别和恰当处理,以获得最佳功能结果并避免并发症。对于这种罕见损伤,切开复位桡骨头并采用梅塔佐技术固定是一种可行的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/b8bfef108c22/JOCR-14-197-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/8c2dc456f966/JOCR-14-197-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/d0024b9340a9/JOCR-14-197-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/9da5765cec8c/JOCR-14-197-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/b8bfef108c22/JOCR-14-197-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/8c2dc456f966/JOCR-14-197-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/d0024b9340a9/JOCR-14-197-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/9da5765cec8c/JOCR-14-197-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2df/11632495/b8bfef108c22/JOCR-14-197-g005.jpg

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本文引用的文献

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Management and Outcome of Jeffrey Type 2 Fractures in Paediatric Patients: A Case Series and Review of Literature.小儿患者Jeffrey 2型骨折的治疗与预后:病例系列及文献综述
J Orthop Case Rep. 2023 May;13(5):34-38. doi: 10.13107/jocr.2023.v13.i05.3636.
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Radial Head Incarceration After Closed Reduction of a Pediatric Elbow Dislocation With a Radial Neck Fracture: A Case Report.桡骨头嵌顿在伴有桡骨颈骨折的小儿肘关节脱位闭合复位后:病例报告。
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