Lateral Humeral Condylar Fractures in Children

兒童之肱骨遠端外踝骨折

王迺輝(Nai-Hwei Wang) ； 崔咸威(Hsian-Wei Tsui) ； 秦凌霄(Lin-Show Chin) ； 羅惠熙(Wai-Hee Lo)

《Journal of Orthopaedic Surgery Taiwan》 10卷4期 (1993/12) Pp. 401-408

摘要

在本院十年間共有四十二例孩童肱骨遠端外踝骨懾接受一年以上追蹤檢查。治療原則根據骨折之移位程度及受傷時間決定。對於骨折未超過一星期，移位小於二毫米，僅予石膏固定及密切追蹤。移位若大於二毫米，則需閉鎖或開放復位及內固定。若經此處理而復位良好，結果均令人滿意。對於陳舊性骨折，若仍在六星期內給予治療，外觀及功能均仍可接受。但若超過六週給予治療，則肘關節僵硬，癒合不良及肘外翻畸形機率均甚高。故對於超過六週之病例均不給予處理，僅治療其後遺症。

並列摘要

Forty-two children with fractures of the lateral humeral condyle were reviewed. Treatment were according to the degree of displacement and the time of injury. In fresh fractures, if initial displacement did not exceed 2mm, simple immobilization in a cast and closely follow-up was the treatment of choice.If the fragment displaced with more than 2mm, it required closed or open reduction and internal fixation. If an adequate reduction was obtained promptly and maintained with fixation, results were uniformly good. As for the treatment of those delayed cases, we found delayed open reduction of those less than 6 weeks after the fracture would expected to have an acceptable cosmetic and functional results, if meticulous and careful dissection was done and adequate fixation provided. However, in those who were treated after 6 weeks period, the incidence of joint stiffness, nor union and cubitus valgus deformity was quite high. Our recommendation was that if the age of the fracture was greater than 6 weeks, it should be left alone. We treated the late complications only.

並列關鍵字

lateral humeral condylar fracture ； nonunion ； malunion ； cubitus varus/valgus ； tardy ulnar nerve palsy.