Li Liuyang, Li Weiqiang, Ma Hong, Zheng Yugeng, Chen Yongge, Ke Huarong, Guo Yueming
Guangzhou University of Traditional Chinese Medicine, The Eighth Clinical Medical College Affiliated Guangzhou University of Traditional Chinese Medicine, Guangdong, China.
Department of Pediatric Orthopedics, Foshan Hospital of Traditional Chinese Medicine, Guangdong, China.
Front Surg. 2025 Mar 18;12:1538399. doi: 10.3389/fsurg.2025.1538399. eCollection 2025.
This study aims to investigate the clinical efficacy of elbow medial approach open reduction and internal fixation with absorbable cannulated screws for the treatment of Kilfoyle II and III type medial condyle fractures of the humerus in children.
A retrospective analysis was conducted on 23 pediatric patients with medial condyle fractures of the humerus who underwent surgical treatment at the Department of Pediatric Orthopedics, Foshan Traditional Chinese Medicine Hospital, from June 2018 to December 2023. Among the patients, 15 were male and 8 were female, with ages ranging from 5 to 12 years (mean age: 9.0 ± 2.4 years). According to the Kilfoyle classification, there were 3 cases of type II fractures and 20 cases of type III fractures. Of these, 19 were fresh fractures and 4 were neglected fractures. The surgical treatment involved open reduction and internal fixation through an elbow medial approach using absorbable cannulated screws. Postoperatively, the elbow joint was fixed in a functional position using a plaster cast. Four weeks postoperatively, follow-up radiographic examination showed continuous callus formation across the fracture line. The plaster cast was then removed, and active flexion and extension exercises of the elbow joint were initiated. The final follow-up assessment was performed using the Broberg-Morrey elbow joint functional scoring system to evaluate treatment efficacy.
All patients were followed up for 3-12 months. All fractures achieved bony union without any breakage of the fixation devices. Among them, 2 cases had good functional scores for the elbow joint, while the others had excellent scores. None of the patients experienced complications such as infection, vascular or nerve injury, nonunion or malunion of fractures, heterotopic ossification, avascular necrosis of the medial epicondyle, or varus/valgus deformity of the elbow joint.
Open reduction and internal fixation through an elbow medial approach using absorbable cannulated screws demonstrates favorable clinical efficacy in treating Kilfoyle II and III type medial condyle fractures of the humerus in children. It can avoid the harm of secondary surgery to children, alleviate their pain, improve elbow joint function, and is considered the preferred method for treating pediatric medial condyle fractures of the humerus, deserving promotion and application in clinical practice.
本研究旨在探讨经肘内侧入路切开复位并用可吸收空心螺钉内固定治疗儿童肱骨髁内侧KilfoyleⅡ型和Ⅲ型骨折的临床疗效。
回顾性分析2018年6月至2023年12月在佛山市中医院小儿骨科接受手术治疗的23例肱骨髁内侧骨折患儿的临床资料。其中男15例，女8例，年龄5～12岁（平均年龄：9.0±2.4岁）。根据Kilfoyle分型，Ⅱ型骨折3例，Ⅲ型骨折20例。其中新鲜骨折19例，陈旧性骨折4例。手术采用经肘内侧入路切开复位，用可吸收空心螺钉内固定。术后用石膏托将肘关节固定于功能位。术后4周随访X线片显示骨折线处有连续骨痂形成，然后拆除石膏托，开始进行肘关节主动屈伸锻炼。末次随访采用Broberg-Morrey肘关节功能评分系统评估治疗效果。
所有患者均获随访3～12个月。所有骨折均达到骨性愈合，固定装置无断裂。其中肘关节功能评分良好2例，其余均为优秀。所有患者均未出现感染、血管或神经损伤、骨折不愈合或畸形愈合、异位骨化、内上髁缺血性坏死、肘关节内翻/外翻畸形等并发症。
经肘内侧入路切开复位并用可吸收空心螺钉内固定治疗儿童肱骨髁内侧KilfoyleⅡ型和Ⅲ型骨折临床疗效良好，可避免二次手术对患儿的伤害，减轻患儿痛苦，改善肘关节功能，是治疗儿童肱骨髁内侧骨折的首选方法，值得临床推广应用。
