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儿童肘部非典型损伤:病例系列

Atypical Injuries of the Elbow in Children: A Case Series.

作者信息

Roy Supratim, Moaiyadi Aliasgar, Patidar Bhavesh, Rode Akshay V, Deshmukh Prithviraj

机构信息

Orthopaedics, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Wardha, IND.

出版信息

Cureus. 2025 May 20;17(5):e84504. doi: 10.7759/cureus.84504. eCollection 2025 May.

Abstract

Fractures occurring in the elbow region of children and adolescents pose a notable challenge for orthopedic surgeons due to the complex anatomy and developmental stages of the humerus. Capitulum fractures, a rare form of elbow injury, are classified into three types according to the Bryan and Morrey classification system. Monteggia fractures, a rare occurrence in children, involve a combination of ulna break and radial head dislocation, with Monteggia equivalent fractures expanding upon traditional classifications. The distinction lies in Monteggia equivalent fractures (MEFs) not always involving proximal radioulnar joint separation. Pediatric cases are further complicated by immature radiocapitellar epiphysis, potentially leading to misdiagnosis or neglect due to concealed joint presentation. This article highlights these rare elbow injuries, emphasizing the need for specialized attention and management. This article presents a case series of four patients with rare elbow injuries that were diagnosed and treated operatively and followed until union with acceptable functional outcome, highlighting the need for early diagnosis and treatment in such cases. Fractures around the elbow in children present diagnostic and therapeutic challenges due to complex anatomy. Capitulum and Monteggia equivalent fractures require careful management to prevent complications. Prompt recognition and treatment, be it closed reduction or open reduction, are crucial for optimal outcomes. Further research on neglected lateral humeral condyle (LHC) fractures is needed to inform clinical decisions.

摘要

儿童和青少年肘部区域发生的骨折,由于肱骨复杂的解剖结构和发育阶段,给骨科医生带来了显著挑战。肱骨小头骨折是一种罕见的肘部损伤形式,根据布莱恩(Bryan)和莫里(Morrey)分类系统可分为三种类型。孟氏骨折在儿童中较为罕见,包括尺骨骨折和桡骨头脱位,孟氏等效骨折在传统分类基础上有所扩展。区别在于孟氏等效骨折(MEFs)并不总是涉及近端桡尺关节分离。儿科病例因桡骨小头骨骺未成熟而进一步复杂化,这可能因关节表现隐匿而导致误诊或漏诊。本文重点介绍了这些罕见的肘部损伤,强调了需要给予专门关注和处理。本文介绍了一组四名患有罕见肘部损伤患者的病例系列,这些患者均接受了手术诊断和治疗,并随访至骨折愈合且功能结果可接受,突出了此类病例早期诊断和治疗的必要性。儿童肘部周围骨折因解剖结构复杂而带来诊断和治疗挑战。肱骨小头骨折和孟氏等效骨折需要仔细处理以预防并发症。无论是闭合复位还是切开复位,迅速识别和治疗对于获得最佳结果至关重要。需要对被忽视的肱骨外侧髁(LHC)骨折进行进一步研究,以为临床决策提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a008/12179346/91571312bb59/cureus-0017-00000084504-i01.jpg

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