儿童肱骨远端骨骺分离27例诊治分析  

Diagnosis and treatment of fracture-separation of distal humeral epiphysis in 27 cases young children

作　　者：王儒法[1] 楼跃[1] 唐凯[1] 张志群[1] 林刚[1] 

机构地区：[1]南京医科大学附属南京儿童医院骨科,210008

出　　处：《临床外科杂志》2012年第2期129-130,共2页Journal of Clinical Surgery

摘　　要：目的 探讨儿童肱骨远端骨骺分离的诊治方法,分析造成误诊的原因.方法 2009年9月至2011年9月收治儿童肱骨远端骨骺分离27例,按照DeLee分型,Ⅰ型1例,Ⅱ型21例,Ⅲ型5例.采用患肢外展水平皮肤牵引26例,2～3周后干骺端有明确骨痂后改石膏托外固定2～3周拆除;手术治疗1例.结果 本组27例,随访1个月～2年,平均1年,肘关节外形及功能均正常,X线显示肱骨远端形态基本正常.结论 儿童肱骨远端骨骺分离属Salter-HarrisⅠ型或Ⅱ型骨骺损伤,多见于婴幼儿,在肘关节的屈伸平面上塑形能力强,因此不必强调切开复位和内固定,外展水平皮肤牵引常可取得良好的近期疗效,远期疗效尚待随访观察.Objective To discuss the diagnosis and treatment of fracture-separation of the distal humeral epiphysis （DHE） in young children and to analyze the causes of misdignosis. Methods From September 2009 to September 2011, altogether 27 cases of DHE fracture-separation were admitted. Based on the DeLee type,there was 1 case of type I ,21 cases of type II, and 5 cases of type m. In 26 cases,the injured arm received horizontal skin traction at abduction, and 2 - 3 weeks later with explicit metaphyseal callus formation,a plaster slab was used for external fixation instead for another 2 - 3 weeks ; In 1 case surgical treatment was performed. Results This group of 27 cases were followed up for 1 month - 2 years （mean, 1 year）, during which the elbow joint g appearance and function were normal, with basicly normal distal humeral shape demonstrated by X-ray. Conclusion The DHE fracture-separation in young children is Sal ter-Harris type I or type II epiphysis injury, mostly occurring in infants, with an acceptable plasticity in the pronation/supination plane of elbow joint. Therefore, open reduction and Kirschner wire fixation are not needed, and horizontal skin traction at abduction can obtain favorable short - term results, but longterm follow-up is still necessary.

关 键 词：儿童 肱骨远端 骨骺分离 

分 类 号：R681.7[医药卫生—骨科学]