文档介绍：儿童肱骨外髁骨折后遗畸形的手术及康复治疗
作者:覃佳强,封林,李明,张德文,刘传康,刘星
【摘要】[目的]探讨儿童肱骨外髁骨折后遗畸形如严重肘外翻、骨不连等的原因及其防治和康复,提高对儿童肱骨外髁骨折的认识。[方法]回顾性总结分析本院2001~2006年间27例肱骨外髁骨折后骨不连、肘外翻畸形的病例,其中男19例,女8例;右侧16例,左侧11例;受伤年龄2~10岁,;手术年龄5~14岁,平均9岁;受伤至手术时间最短8个月,最长10年,。根据不同情况,共采用3种术式,其中直接行骨折块原位内固定7例,切开复位、髂骨取骨植骨内固定11例,肱骨远端内翻楔形截骨矫形9例。[结果]获得2年以上随访14例,6个月~2年,13例。所有病例均在术后8~16周形成骨愈合,肘部畸形得到不同程度的矫正,肘关节功能得到不同程度恢复,疗效较满意。根据肘部外形、活动功能和并发症分为优、良、差3个等级,其中优13例,良11例,差3例,%。术后无骨坏死、创伤性关节炎及骨化性肌炎的发生。[结论]对儿童肱骨外髁骨折认识不足,治疗不及时或治疗方案选择不恰当,是导致骨不连和儿童肱骨外髁骨折后遗畸形如严重肘外翻、骨不连等的主要因素,后遗畸形导致功能障碍,恢复较困难。针对不同的情况早期采取相应的手术方式,辅以多种功能锻炼,能有效改善肘关节的外观和功能。
【关键词】儿童; 肱骨外髁骨折;骨不连;畸形
Open reduction and rehabilitation of the deformity after humeral lateral condyle fractures in children
Abstract:[Objective]To investigate etiopathogenisis, modus operandi and rehabilitation in treatment of bone nonunion and residual deformity (cubitus valgus) after humeral lateral condyle fractures in children. [Method]The author retrospective summarized a total of 27 patients diagnosed with humeral lateral condyle fracture follow with bone nonunion and/or cubitus valgus consecutive enrolled in Children’s Hospital of Chongqing Medical University from 2001 to 2006, including 19 cases of male, 8 cases of female, 16 cases of right humeral lateral condyle fracture and 11 cases of left. The mean age at injured for all the patients (n =27) was yr (range 3–10 yr).The mean age at suigical operation for all the patients (n =27) was 9 yr (range 5–14 yr).The average time from injury to operation was yr (range 8mon–10 yr).There were three modus operations including direct normal position internal fixation of 7 cases, open reduction following os illium bone graft internal fixation of 11 cases, distant humerus varus wedge shape cut orthopaedic for 9 cases.[Result]Thirteen patients were followed up ranging from 6 month to 2 years, and 14 patients over 2 years. All the patients were achieved union for 8 to 16 weeks after surgery. Elbow deformity had been corrected and