肱骨外髁骨折是低龄儿童常见肘部损伤之一。损伤机制主要为肘关节伸直时前臂在内翻或外翻应力下发生。大部分情况下,X线可以明确诊断,但对于没有移位及外髁尚未骨化骨折,MRI或肘关节造影可以进一步明确诊断。对于骨折移位 ≤ 2 mm且关...肱骨外髁骨折是低龄儿童常见肘部损伤之一。损伤机制主要为肘关节伸直时前臂在内翻或外翻应力下发生。大部分情况下,X线可以明确诊断,但对于没有移位及外髁尚未骨化骨折,MRI或肘关节造影可以进一步明确诊断。对于骨折移位 ≤ 2 mm且关节面平整的患儿首选保守治疗。闭合复位经皮克氏针固定适用于骨折移位 > 2 mm且关节面铰链完整者。而骨折块移位 ≥ 4 mm伴骨折块翻转,关节面不平整者,首选切开复位内固定治疗。主要并发症包括畸形愈合、延迟愈合、鱼尾畸形、外侧过度生长及生长停滞。本文旨在对儿童肱骨外髁骨折进行全面概述,以提高广大基层医生对儿童肱骨外髁骨折的认识及为患儿选择最合理的治疗方式。Humeral lateral condyle fracture is one of the most common elbow injuries in young children. The injury mechanism mainly occurs under varus or valgus stress of the forearm during elbow extension. In most cases, X-ray can confirm the diagnosis, but MRI or elbow arthrography can further confirm the diagnosis of fractures without displacement or ossification of the lateral condyle. Conservative treatment is the first choice for children with fracture displacement ≤ 2 mm and flat articular surface. Closed reduction and percutaneous Kirschner wire fixation suitable for patients with fracture displacement > 2 mm and intact articular surface hinge. Open reduction and internal fixation are the first choice for patients with fracture displacement ≥ 4 mm, inversion of fracture fragment and uneven articular surface. The main complications included malunion, delayed union, fishtail deformity, lateral overgrowth and growth arrest. This article aims to provide a comprehensive overview of pediatric humeral condyle fractures, in order to improve the understanding of primary care doctors towards pediatric humeral condyle fractures and to select the most reasonable treatment methods for children.展开更多
文摘肱骨外髁骨折是低龄儿童常见肘部损伤之一。损伤机制主要为肘关节伸直时前臂在内翻或外翻应力下发生。大部分情况下,X线可以明确诊断,但对于没有移位及外髁尚未骨化骨折,MRI或肘关节造影可以进一步明确诊断。对于骨折移位 ≤ 2 mm且关节面平整的患儿首选保守治疗。闭合复位经皮克氏针固定适用于骨折移位 > 2 mm且关节面铰链完整者。而骨折块移位 ≥ 4 mm伴骨折块翻转,关节面不平整者,首选切开复位内固定治疗。主要并发症包括畸形愈合、延迟愈合、鱼尾畸形、外侧过度生长及生长停滞。本文旨在对儿童肱骨外髁骨折进行全面概述,以提高广大基层医生对儿童肱骨外髁骨折的认识及为患儿选择最合理的治疗方式。Humeral lateral condyle fracture is one of the most common elbow injuries in young children. The injury mechanism mainly occurs under varus or valgus stress of the forearm during elbow extension. In most cases, X-ray can confirm the diagnosis, but MRI or elbow arthrography can further confirm the diagnosis of fractures without displacement or ossification of the lateral condyle. Conservative treatment is the first choice for children with fracture displacement ≤ 2 mm and flat articular surface. Closed reduction and percutaneous Kirschner wire fixation suitable for patients with fracture displacement > 2 mm and intact articular surface hinge. Open reduction and internal fixation are the first choice for patients with fracture displacement ≥ 4 mm, inversion of fracture fragment and uneven articular surface. The main complications included malunion, delayed union, fishtail deformity, lateral overgrowth and growth arrest. This article aims to provide a comprehensive overview of pediatric humeral condyle fractures, in order to improve the understanding of primary care doctors towards pediatric humeral condyle fractures and to select the most reasonable treatment methods for children.
