Mintzer C M, Waters P M, Brown D J, Kasser J R
Harvard Combined Orthopedic Surgery Program, Boston, Massachusetts.
J Pediatr Orthop. 1994 Jul-Aug;14(4):462-5. doi: 10.1097/01241398-199407000-00008.
This is a review of a unique group of 12 children with lateral condyle fractures of the distal humerus with displacement of > 2 mm. Intraoperative arthrograms of each elbow demonstrated no articular incongruity associated with minimal rotation of the distal fracture fragment. After closed reduction the lateral condyle fractures were percutaneously pinned, obviating the need for open reduction and internal fixation. The results in this study group were uniformly excellent as based on the rating system of Hardcare. Each child had a normal range of elbow motion and all cases healed clinically and radiographically without complication. Previous literature has recommended that all lateral condyle fractures displaced > 2 mm be treated with open reduction and internal fixation. The authors feel that in selected cases of lateral condyle fractures with > 2 mm displacement and an arthrographically demonstrated congruent joint surface, percutaneous pinning may safely and effectively be performed.
这是对一组12名肱骨远端外侧髁骨折且移位大于2毫米的独特儿童病例的回顾。每个肘部的术中关节造影显示，远端骨折块仅有轻微旋转，未出现关节不匹配情况。闭合复位后，外侧髁骨折采用经皮穿针固定，无需切开复位内固定。根据Hardcare评分系统，该研究组的结果均为优。每个儿童的肘部活动范围正常，所有病例在临床和影像学上均愈合良好，无并发症。以往文献建议，所有移位大于2毫米的外侧髁骨折均采用切开复位内固定治疗。作者认为，对于部分移位大于2毫米且关节造影显示关节面匹配的外侧髁骨折病例，可安全有效地进行经皮穿针固定。
