Davids J R, Maguire M F, Mubarak S J, Wenger D R
Department of Orthopaedics, Children's Hospital and Health Center, University of California, San Diego.
J Pediatr Orthop. 1994 Jul-Aug;14(4):466-70. doi: 10.1097/01241398-199407000-00009.
Posttraumatic cubitus varus is widely regarded as just a cosmetic deformity. Six cases of lateral condylar fracture of the humerus in children with preexisting cubitus varus due to prior elbow fracture are presented. Five occurred following malunited extension-type supracondylar fractures of the humerus; the other occurred following a lateral condylar fracture complicated by lateral overgrowth. All cases were treated by anatomic reduction (two closed, four open) and percutaneous pinning of the lateral condylar fracture. Three of the six cases subsequently underwent supracondylar osteotomy of the distal humerus to correct the underlying varus malalignment. Biomechanical analysis suggests that both the torsional moment and the shear force generated across the capitellar physis by a routine fall are increased by varus malalignment. Posttraumatic cubitus varus may predispose a child to subsequent lateral condylar fracture and should be viewed as more than just a cosmetic deformity.
创伤后肘内翻通常被认为只是一种外观畸形。本文报告6例儿童肱骨髁上骨折后出现肘内翻畸形，其中5例继发于肱骨髁上伸直型骨折畸形愈合，另1例继发于肱骨外侧髁骨折合并外侧过度生长。所有病例均采用解剖复位（2例闭合复位，4例切开复位）及经皮穿针固定外侧髁骨折。6例中有3例随后接受了肱骨远端髁上截骨术以纠正潜在的内翻畸形。生物力学分析表明，内翻畸形会增加日常跌倒时通过肱骨小头骨骺产生的扭矩和剪切力。创伤后肘内翻可能使儿童易发生后续的外侧髁骨折，不应仅被视为外观畸形。
