肱骨经髁骨折  

Transcondylar Fracture of Humerus

作　　者：俞辉国[1] 童学波[1] 

机构地区：[1]上海第二医科大学附属瑞金医院小儿骨科,200025

出　　处：《中华小儿外科杂志》1999年第2期99-100,共2页Chinese Journal of Pediatric Surgery

摘　　要：目的　研究肱骨经髁骨折的诊断和治疗， 以避免误诊和肘内翻发生。方法　报道１６例肱骨经髁骨折， 男１０ 例， 女６ 例。年龄从分娩第一天到７ 岁， 平均３ 岁。结合文献资料进行回顾和分析。结果　本组２ 例误诊为肘关节脱位，１ 例误诊为肱骨外髁骨折，１ 例闭合复位失败改行切开复位。余均采用闭合复位。随访１２ 例， 随访时间２ ～１０ 年， 治疗效果良好。结论　Ｄｅｌｅｅ Ａ 型需和肘关节脱位鉴别，Ｂ型和Ｃ型由于肱骨小头骨化中心出现， 小头和挠骨近侧的正常关系成为诊断的关键。笔者主张闭合复位， 长臂石膏后托固定于屈肘， 前臂旋前位， 以维持复位， 减少肘内翻。Objective To review the experience in management of transcondylar fracture of humerus in children. Methods Sixteen children, 10 boys and 6 girls, with transcondylar fracture of humerus, were followed up for 2 to 10 years. The fracture was categorised into type A (n=6), B(n=6) and C(n=4) according to Delee's classification. Results Two patients were misdiagnosed as dislocation of elbow and one as fracture of the lateral condyle of the humerus. Close reduction was carried out in 12 patients with excellent results. Conclusions Delee type A fracture should be differentiated from dislocation of elbow. Close reduction is the treatment of choice. A line drawn along the long axis of radius, which usually passes through capitulum, is the key to diagnose type B and C fractures. The elbow should be fixed in flexed position with forearm pronated. This minimised cubitus varus deformity and displacement during immobilization.

关 键 词：肱骨经髁骨折 肱骨骨折 诊断 治疗 儿童 

分 类 号：R726.834.1[医药卫生—儿科]