Capitellar and Lateral Epicondylar Fracture with Valgus Instability of the Elbow Joint － Case Report

肱骨小頭及外側上髁骨折合併肘關節外翻性不穩 － 病例報告

許世祥(Shih-Hsiang Hsu) ； 陳英和(Ing-Ho Chen)

《慈濟醫學雜誌》 14卷4期 (2002/08) Pp. 257-261

https://doi.org/10.6440/TZUCMJ.200208.0257

摘要

肱骨小頭骨折是一種肱骨末端之罕見骨折，第四型肱骨小頭骨折同時併有肱骨外側上髁骨折及肘關節外翻性不穩，更是少見。由於常有困難取得清楚的骨折放射線影像以供判讀，此種關節內骨折初診時常見誤診。我們提出此種病例，以湯瑪斯氏所提之橈骨頭部－肱骨小頭的修正照相法，可顯示出由肱骨末端的不規則骨折下緣所形成，以前未曾報告過的放射學獨特病理表徵。患者接受開放性復位及螺絲固定之外科手術治療，術後經由監導下儘早復健運動訓練後，可得良好之結果。有充分好的放射線照像檢查，才可得到正確的肱骨小頭骨折認定及分類，終而引領至適當的治療。

關鍵字

肱骨小頭骨折 ； 肱骨外側上髁骨折 ； 赫伯氏螺絲

並列摘要

Capitellar fracture is a rare type of fracture in the distal humerus. More rarely, type IV capitellar fracture is combined with lateral epicondylar fracture and valgus instability of the elbow joint. This intra-articular fracture is frequently missed on first examination due to difficulty in getting a clear radiological image to interpret. We present a patient with this type of injury. A Tomas-proposed modified radial head-capitellum view showed a radiological pathognomic feature with an irregular inferior fracture margin of distal humerus, which has not been reported previously. He received open reduction and screw fixation for the fracture. An early controlled postoperative rehabilitational exercise program led to excellent results. Accurate identification and classification of capitellar fracture seen on adequate radiological examination can direct us to an appropriate treatment.

並列關鍵字

Capitellar fracture ； epicondylar fracture ； Herbert screw