儿童肘部损伤后肘外翻畸形  

Cubitus Valgus Deformity Followiag Elbow Trauma in Children

作　　者：黄耀添[1] 刘金祥[1] 李稔生[1] 傅炳峨[1] 

机构地区：[1]第四军医大学西京医院全军骨科研究所,西安710032

出　　处：《中华小儿外科杂志》1996年第5期288-290,共3页Chinese Journal of Pediatric Surgery

摘　　要：为了积极有效地治疗儿童肘部损伤后发生的肘外翻畸形，对肘外翻发生的原因、预防和治疗进行讨论。本组共２６例，肘部损伤时年龄２～１４岁（平均７．５岁）。儿童肘部损伤为肱骨外髁骨析１４例，肱骨外髁骨折合并桡骨小头脱位１例，肱骨髁上骨折８例，肱骨内髁骨折１例，桡骨小头脱位２例。肘关节提携角２０～４５（平均２８）。合并创伤性尺神经炎１９例，创伤性关节炎７例。１９例合并创伤性尺神经炎作神经松解前移术，平均随访６．６年，优良率８８．２％。５例肘外翻作肪骨髁上截骨术，平均随访９．４年，肘关节外观及功能满意。结论：延误诊治、复位固定不良是儿童肘部损伤后发生肘外翻的原因。早期诊断、及时准确复位和确切固定是减少肘外翻发生的重要措施，对有移位的骨折的反复手法复位可加重骨骺损伤。８岁以上严重肘外翻畸形可作肱骨髁上截骨术矫正，合并创伤性尺神经炎应早期作尺神经松解前移术。Twenty-six cases with cubitus deformity following elbow trauma are reported. The age ranged from 2～14 years (mean 7. 5 yrs ) . The elbow traumas included : fractures of the lateral condyle of the humerus (14 ) , fracture of lateral condyle associated with dislocation of the radial head (1) . supracondylar fractures (8) , fractures of medial condyle (2) , and dislocations of radial head (2) . The late complications included : traumatic ulnar neuritis . (19) and traumatic arthritis (7) . Neurolysis and anterior transposition of ulnar nerve were performed on 19 .cases with traumatic ulnar neuritis. The follow-up study (mean 6. 6 years ) showed excellent and good results in 88. 2%. Supracondylar osteotomy of the humerus for correction of cubitus valgus were done on 5 cases and were follow-up for 9. 4 years in average . A satisfactory function and good appearance of the elbow was obtained. Repeated manipulation of the displaced fracture may cause impairment of the epiphysis. A supracondylar humeral osteotozny should be performed on patients over 8 years of age with obvious deformity. The complicated ulnar neuritis should be treated by eazly neurolysis and anterior transposition.

关 键 词：肘关节 前臂损伤 外翻畸形 外科手术 儿童 

分 类 号：R726.825[医药卫生—儿科] R726.873[医药卫生—临床医学]