CAJ | 학술논문

目的探讨儿童肱骨外髁骨折的早期诊断和治疗策略.方法回顾性分析2010年7月至2012年7月收治的15例儿童肱骨外髁骨折的病例资料,采用早期切开复位克氏针内固定手术治疗,术后按照Flynn功能评定标准,结合影像学对肘关节功能进行评定.结果所有患儿均获得13 ～ 27个月的随访,平均18.5个月.15例骨折均愈合,时间为1.4～2.7个月,平均2.0个月,无一例出现骨不连或骨延迟愈合.按Flynn功能评定标准评定:优13例,良2例.结论儿童肱骨外髁骨化中心出现时间晚,X线片上常不显影,发生骨折后极易导致误诊或漏诊.早期诊断可以减少各种畸形的发生,切开复位交叉克氏针固定具有复位满意、固定牢靠及并发症少等优点,是目前治疗儿童肱骨外髁骨折较为理想的方法.
목적 탐토인동굉골외과골절적조기진단화치료책략.방법 회고성분석2010년7월지2012년7월수치적15례인동굉골외과골절적병례자료,채용조기절개복위극씨침내고정수술치료,술후안조Flynn공능평정표준,결합영상학대주관절공능진행평정.결과 소유환인균획득13 ～ 27개월적수방,평균18.5개월.15례골절균유합,시간위1.4～2.7개월,평균2.0개월,무일례출현골불련혹골연지유합.안Flynn공능평정표준평정:우13례,량2례.결론 인동굉골외과골화중심출현시간만,X선편상상불현영,발생골절후겁역도치오진혹루진.조기진단가이감소각충기형적발생,절개복위교차극씨침고정구유복위만의、고정뢰고급병발증소등우점,시목전치료인동굉골외과골절교위이상적방법.
Objective To investigate the early diagnosis and treatment strategies of lateral condylar fractures of humerus in children.Methods From July 2010 to July 2012,15 patients with humeral lateral condyle fractures were treated with open reduction and internal fixation with Kirschner wires in our hospital.The treatment outcomes were assessed using Flynn functional criteria and radiographical assessment of osteoarthritis or heterotopic ossification around the elbow.Results All the patients were follow-up for a mean time of 18.5 months (range,13 to 27 months).Bony healing was achieved in all the patients,within an average of 2.0 months (range,1.4 to 2.7 months).No nonunion and delayed union were observed in X-ray films.According to Flynn criteria,the results were excellent in 13 cases and good in 2 cases.Conclusion Displaced humerus lateral condyle fracture is easy to be misdiagnosed or missed because ossification occurs late in children.The fracture therefore doesn't show on X-rays.Early diagnosis is important in order to reduce various deformities and complications.Open reduction and crossed Kirschner wire fixation can lead to satisfactory reduction and firm fixation with fewer complications.At present it is an ideal method for treatment of lateral condylar fracture of humerus in children.