McKee M D, Jupiter J B, Bamberger H B
Massachusetts General Hospital, Boston 02114, USA.
J Bone Joint Surg Am. 1996 Jan;78(1):49-54. doi: 10.2106/00004623-199601000-00007.
We identified a shear fracture of the distal articular surface of the humerus, with anterior and proximal displacement of the capitellum and a portion of the trochlea, in six patients (five female and one male). The average age of the patients was thirty-eight years (range, ten to sixty-three years). Each fracture was the result of a fall from a standing height. A characteristic radiographic abnormality, which we have termed the double-arc sign, was seen on the lateral radiograph of each patient and represented the subchondral bone of the displaced capitellum and the lateral trochlear ridge. All patients were managed with open reduction, internal fixation, and early motion of the elbow. The average duration of follow-up was twenty-two months (range, eighteen to twenty-six months). The fracture united in all patients at an average of six weeks (range, four to nine weeks), without radiographic evidence of osteonecrosis of the fracture fragment. Flexion of the elbow averaged 141 degrees (range, 130 to 150 degrees), with an average flexion contracture of 15 degrees (range, 0 to 40 degrees). Pronation of the forearm averaged 83 degrees, and supination averaged 84 degrees. All patients had a good or excellent functional result, according to the elbow-rating scale of Broberg and Morrey.
我们在6例患者（5例女性，1例男性）中发现了肱骨远端关节面的剪切骨折，伴有肱骨小头和部分滑车向前及近端移位。患者的平均年龄为38岁（范围为10至63岁）。每例骨折均为从站立高度跌落所致。在每位患者的侧位X线片上均可见一种特征性的影像学异常，我们称之为双弧征，它代表移位的肱骨小头的软骨下骨和外侧滑车嵴。所有患者均接受了切开复位、内固定及早期肘关节活动治疗。平均随访时间为22个月（范围为18至26个月）。所有患者的骨折均在平均6周（范围为4至9周）时愈合，骨折碎片无影像学证据显示骨坏死。肘关节屈曲平均为141度（范围为130至150度），平均屈曲挛缩为15度（范围为0至40度）。前臂旋前平均为83度，旋后平均为84度。根据Broberg和Morrey的肘关节评分标准，所有患者的功能结果均为良好或优秀。
