Kang Chi, Xiao Yuan, Huang Yuhan, Liu Qinghua, Deng ZhiQiang, Liu Xin
Children's Orthopedics Department, Sichuan Provincial Orthopedic Hospital, Chengdu, China.
J Orthop Surg Res. 2025 Jul 15;20(1):655. doi: 10.1186/s13018-025-06053-y.
The purpose of this study was to investigate the characteristics, treatment methods, and functional outcomes of children with Dubberley Type IIA capitellar fractures.
We conducted a retrospective analysis of pediatric patients diagnosed and surgically treated for capitellar fractures at the Pediatric Orthopedics Department of Sichuan Provincial Orthopedic Hospital from June 2018 to June 2024. Fractures were classified according to the Dubberley system, and functional outcomes were evaluated using the Mayo Elbow Performance Score (MEPS) at the final follow-up.
Among the cohort, 26 children (22 males, 4 females; age range 9-14 years, mean 13 years) were identified with Dubberley Type IIA capitellar fractures. All patients underwent surgical treatment via a lateral elbow approach: 11 cases received cannulated screw fixation alone, while 15 cases were treated with cannulated screws combined with buttress plates. Follow-up ranged from 8 to 35 months (mean 17.5 months). At the final follow-up, all fractures had healed without complications such as nonunion, osteonecrosis of the capitellum, or heterotopic ossification. The MEPS excellent/good rate was 100%.
The displacement pattern of Dubberley Type IIA capitellar fractures in children predominantly involves proximal rotation of the lateral aspect of the fracture fragment in the coronal plane, centered on the medial aspect of the fracture fragment. Early and accurate diagnosis combined with surgical intervention resulted in favorable functional recovery and significant therapeutic efficacy. Key factors for successful outcomes include anatomical reduction of the fracture, restoration of joint congruency, stable fixation, and early postoperative functional rehabilitation.
本研究旨在探讨杜伯利IIA型肱骨小头骨折患儿的特点、治疗方法及功能预后。
我们对2018年6月至2024年6月在四川省骨科医院小儿骨科诊断并接受手术治疗的肱骨小头骨折患儿进行了回顾性分析。骨折根据杜伯利系统进行分类，在末次随访时使用梅奥肘关节功能评分（MEPS）评估功能预后。
在该队列中，确定有26例儿童（男22例，女4例；年龄范围9 - 14岁，平均13岁）患有杜伯利IIA型肱骨小头骨折。所有患者均通过外侧肘入路接受手术治疗：11例仅接受空心螺钉固定，15例采用空心螺钉联合支撑钢板治疗。随访时间为8至35个月（平均17.5个月）。在末次随访时，所有骨折均愈合，未出现骨不连、肱骨小头缺血性坏死或异位骨化等并发症。MEPS优良率为100%。
儿童杜伯利IIA型肱骨小头骨折的移位模式主要表现为骨折块外侧在冠状面以骨折块内侧为中心向近端旋转。早期准确诊断并结合手术干预可实现良好的功能恢复及显著的治疗效果。成功预后的关键因素包括骨折的解剖复位、关节面的恢复、稳定固定及术后早期功能康复。
